Aspirin desensitization
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Keri Shafer, M.D.
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Overview
Approximately 10% of the population experiences hypersensitivity to aspirin, which can manifest as asthma exacerbations, rhinorrhea, angioedema, urticaria, and anaphylaxis. Dual antiplatelet therapy with both aspirin and clopidogrel has been associated with improved clinical outcomes. Patients with aspirin hypersensitivity are sometimes instead managed with clopidogrel monotherapy with no supporting data. Aspirin desensitization is required when continued aspirin administration is essential (e.g. management of an acute coronary syndrome with stent placement). A rapid protocol can be used as described below. [1]. While this protocol can be implemented over the course of several hours, it may not applicable to those patients who must proceed to the cardiac catheterization laboratory.
Mechanism of Aspirin Desensitization
Protocol for Aspirin Desensitization:
The dose of aspirin is increased every 15 minutes until the maximum dose of aspirin is administered:
Dose #
- 0.1 mg
- 0.3 mg
- 1 mg
- 3 mg
- 10 mg
- 20 mg
- 40 mg
- 81 mg
- 162 mg
- 325 mg
References
- ↑ Page NA, Schroeder WS (2007). "Rapid desensitization protocols for patients with cardiovascular disease and aspirin hypersensitivity in an era of dual antiplatelet therapy". The Annals of Pharmacotherapy. 41 (1): 61–7. doi:10.1345/aph.1H437. PMID 17200429. Retrieved 2010-07-01. Unknown parameter
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