Aspirin Allergy???

[ksbparagod]

We have been running into a lot of people telling us lately that they have an allergy to aspirin. What we have found out is that most of these people have been told to tell people that when they are on Coumadin or Plavix. So just question them if this is in your protocols to give aspirin.

[Ridryder 911]

I usually ask what "allergy" symptoms that occurred. If it is that they did not have any true allergic reactions , rather they are on an anti-coagulant, then I will administer ASA anyway. Many practitioners are misinforming clients that they are allergic instead of teaching them correctly, to be cautious in using any potential blood thinners.

One has to be cautious in administering any ASA products, but the recommended one time dosage should not be that detrimental.

All else fails, I will consult medical control.

R/r 911

[hammerpcp]

I also frequently come across this. As Rid said if you ask a few questions you can usually figure out whether it is an actual allergy or not, and thus whether you can administer ASA.

[Doczilla]

Some people will list an "allergy" to any medicine to which they feel they have had any side effect or adverse reaction. They may list a penicillin allergy when really they had mild nausea when they took it. Or they will list a phenergan allergy because it made them sleepy. I would swear that some people take pride in the number of allergies they list, or maybe just in being a PITA patient in general. Others list and allergy because they read on the internet that one of their medicines will interact with another medicine (like the ASA/plavix thing or phenergan and levaquin), but don't really have any concept of the importance or lack thereof of the specific interaction. For this reason, it's always important to ask them to characterize the symptoms that they have with each of their allergies.

Unless you have rash or full-blown anaphylaxis to aspirin, or have a specific platelet disorder, everyone with suspected ACS gets aspirin.

More than 5 listed allergies = borderline personality disorder (BPD).

'zilla

[aussiephil]

I know the studies that prove the benefits of ASA use.

I know patients dont understand the difference between an allergy & an adverse reaction.

I know some Medical staff do not tell the whole truth regarding allergies.

What about consent?

IF the patient believes that they have an allergy, either true or false & they do not want to take it, we cant force them, can we?

[dahlio]

Aspirin is not in our scope of practice here in NJ. Couldn't you better interrogate a patient/patient's family to know to what extent they are allergic. If it's your normal side affects, then they most likely aren't allergic. However, this brings up a dilemma, since you could get in trouble if you do decide to administer aspirin, and they are in fact allergic, then you're looking at a lawsuit.

So now after my rambling on about interrogating patients/patient's family's, screw that, and don't administer it. Document it well, and it shouldn't give you problems.

[ksbparagod]

I was just looking to see if anyone else has run in to this situation. I do like you all said and ask what the exact reaction is and then inform the patient of the risks and benefits or taking the ASA and if they still refuse to take the ASA I document the living daylights out of it so that I CMOA. Thanks everyone for your input.

[Dustdevil]

Some people will list an "allergy" to any medicine to which they feel they have had any side effect or adverse reaction.'zilla

Then there are those who list an allergy because they once heard that their great aunt on their step-father's side was allergic to it. And, of course, the ones who list an allergy because they feel the drug didn't work for them last time. And the asthmatics who have never had a reaction to ASA, but were told years ago that they shouldn't take it. Because of that, a patient should ALWAYS be queried about what specifically happens if/when they take/took that drug. A good amount of the time, they say they never have even taken it.

More than 5 listed allergies = borderline personality disorder (BPD).

LMAO!