<html> <head> <meta charset="UTF-8"/> <meta name="tikaGenerated" content="true"/> <meta name="date" content="2020-04-07T23:33:52Z"/> <meta name="xmp:CreatorTool" content="Acrobat PDFMaker 15 for Word"/> <meta name="Company" content="SA Health"/> <meta name="Keywords" content="Neonatal Medication Guideline, aspirin, thromboprophylaxis"/> <meta name="subject" content="Neonatal Medication Guideline"/> <meta name="dc:creator" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/> <meta name="dcterms:created" content="2020-04-07T23:33:50Z"/> <meta name="Last-Modified" content="2020-04-07T23:33:52Z"/> <meta name="dcterms:modified" content="2020-04-07T23:33:52Z"/> <meta name="title" content="Aspirin"/> <meta name="Last-Save-Date" content="2020-04-07T23:33:52Z"/> <meta name="meta:save-date" content="2020-04-07T23:33:52Z"/> <meta name="dc:title" content="Aspirin"/> <meta name="modified" content="2020-04-07T23:33:52Z"/> <meta name="cp:subject" content="Neonatal Medication Guideline"/> <meta name="Content-Type" content="application/pdf"/> <meta name="creator" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/> <meta name="meta:author" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/> <meta name="dc:subject" content="Neonatal Medication Guideline, aspirin, thromboprophylaxis"/> <meta name="meta:creation-date" content="2020-04-07T23:33:50Z"/> <meta name="created" content="Wed Apr 08 09:03:50 ACST 2020"/> <meta name="xmpTPg:NPages" content="2"/> <meta name="Creation-Date" content="2020-04-07T23:33:50Z"/> <meta name="SourceModified" content="D:20200407230313"/> <meta name="meta:keyword" content="Neonatal Medication Guideline, aspirin, thromboprophylaxis"/> <meta name="Author" content="SA Maternal, Neonatal & Gynaecology Community of Practice"/> <meta name="producer" content="Adobe PDF Library 15.0"/> </head> <body> <pre> South Australian Neonatal Medication Guidelines Aspirin 300mg soluble tablet Department for Health and Wellbeing, Government of South Australia. All rights reserved. INFORMAL COPY WHEN PRINTED Page 1 of 2 Public-I4-A1 Note: This guideline provides advice of a general nature. This statewide guideline has been prepared to promote and facilitate standardisation and consistency of practice, using a multidisciplinary approach. The guideline is based on a review of published evidence and expert opinion. Information in this statewide guideline is current at the time of publication. SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site and does not sponsor, approve or endorse materials on such links. Health practitioners in the South Australian public health sector are expected to review specific details of each patient and professionally assess the applicability of the relevant guideline to that clinical situation. If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must document in the patient s medical record, the decision made, by whom, and detailed reasons for the departure from the guideline. This statewide guideline does not address all the elements of clinical practice and assumes that the individual clinicians are responsible for discussing care with consumers in an environment that is culturally appropriate and which enables respectful confidential discussion. This includes: The use of interpreter services where necessary, Advising consumers of their choice and ensuring informed consent is obtained, Providing care within scope of practice, meeting all legislative requirements and maintaining standards of professional conduct, and Documenting all care in accordance with mandatory and local requirements Dose and Indications Thromboprophylaxis post cardiac surgery Oral 1 to 5mg/kg once daily Preparation and Administration Oral Disperse a 300mg tablet in 30mL of sterile water; this will give a 10mg/mL aspirin mixture. The mixture should be stirred intermittently for a few minutes while dispersing. Before withdrawing dose, pump the mixture in and out of the syringe four times to ensure the best possible drug distribution. Dose 1mg 2mg 3mg 4mg 5mg Volume 0.1mL 0.2mL 0.3mL 0.4mL 0.5mL Withdraw dose and administer immediately. Use a fresh tablet for each dose and discard any remaining solution. Adverse Effects Common Nausea, vomiting, abdominal pain, gastrointestinal upset, asymptomatic blood loss Infrequent Dyspnoea, rhinitis, severe cutaneous adverse reactions (SCARs), skin reactions, gastrointestinal haemorrhage South Australian Neonatal Medication Guidelines Aspirin 300mg soluble tablet INFORMAL COPY WHEN PRINTED Page 2 of 2 Public-I4-A1 Rare Reye s syndrome (more common with doses >40mg/kg/day), aplastic anaemia, erythema nodosum, granulocytosis, haemorrhagic vasculitis, intracranial haemorrhage, nausea, thrombocytopenia, vomiting Allergic reaction Bronchospasm, angioedema, urticaria and rhinitis have been precipitated by aspirin; there is cross-reactivity with other non-steroidal anti-inflammatory drugs (NSAIDs) Monitoring > Monitor for symptoms of salicylism including sweating, vomiting, nasal congestion and slight hyperpyrexia. Symptoms of severe salicylate toxicity include hyperventilation, restlessness, irritability, hyperthermia and alterations in acid-base balance, primarily respiratory alkalosis. Practice Points > The use of aspirin in infants for the treatment of fever and muscle ache associated with viral illness should be avoided due to the association with Reye s syndrome > Use with caution in renal impairment, allergic disease, anaemia, dehydration, G6PD deficiency, thyrotoxicosis, uncontrolled hypertension and thrombocytopenia > Contraindicated in severe active bleeding or disease states with an increased risk of severe bleeding (e.g. bleeding disorders, erosive gastritis or peptic ulcer disease, severe hepatic disease, allergy to aspirin or NSAIDs) Practice Points > Brustugun J, et al, Adjusting the dose in paediatric care: dispersing four different aspirin tablets and taking a portion, European Journal of Hospital Pharmacy, 2019 Document Ownership & History Developed by: SA Maternal, Neonatal & Gynaecology Community of Practice Contact: Health.NeoMed@sa.gov.au Endorsed by: SA Health Safety and Quality Strategic Governance Committee Next review due: 03/04/2025 ISBN number: 978-1-76083-175-2 PDS reference: CG332 Policy history: Is this a new policy (V1)? Y Does this policy amend or update and existing policy? N If so, which version? Does this policy replace another policy with a different title? N Approval Date Version Who approved New/Revised Version Reason for Change 03/04/2020 V1 SA Health Commissioning and Performance Division Original approved version </pre> </body> </html>