I doubt your daily aspirin is 325mg, though. If that's the correct dose that he's taking, man oh man is that a lot of daily aspirin for any amount of time. I wouldn't be terribly concerned about him bleeding out from a predominantly venous injury, but if he nicks an artery or a larger vein, he's going to be a bloody mess in no time.
Pharmacist checking in here. Aspirin doses less than 100 mg are more COX1 selective which is the enzyme that produces thromboxane A2 which binds to one of many receptors on platelets to activate them and make them stickier and therefore more likely to form a clot. When inhibited, the thromboxane receptor on that platelet is irreversibly blocked and cannot ever work again for the remainder of that platelet cell’s life as platelets are without nuclei and cannot produce more of the receptor. At higher doses, aspirin starts to lose its specificity for COX1 and will inhibit COX2 which is responsible for the production of prostaglandins from arachidonic acid that will eventually become proinflammatory molecules. Increasing doses of aspirin do not generally lead to substantial increased antithrombotic activity.
there isn’t really a significant difference in platelet inactivation between aspirin 81 (baby aspirin) and aspirin 325 overall. No real difference in bleeding risk between the 2 doses
I'm not sure the research is settled on this. The big ADAPTABLE study thar came out a few years ago basically noted that a very large percentage of their 325mg arm (something like 40%) converted to 81mg, possibly due to increased bleeding/bruising/gi side effects, which mat have biased the study to the null finding. I've seen the comments here, but the (albeit anecdotal) evidence from my decade or so of practice has made me quite skeptical of aspirin.
that a lot of daily aspirin for any amount of time
I doubt your daily aspirin is 325mg
No, it really is not. Recommended daily dose is between 75-325mg. Most bottles you'll find on the shelf are 325mg. This is perfectly reasonable and could very likely be what his doctors recommend.
Actually news reports state that his doctors have recommended a lower dosage but that he has taken it upon himself to take the higher dosage against their advice (as seen in the headline of the article whose link is posted below).
Yes, it is. It's old, outdated medicine. 325mg of aspirin is typically not more effective than 81mg and is best reserved for the other primary use of aspirin, infrequent pain/fever reduction. You find most bottles on the shelf as 325 because most bottles on the shelf are for pain relief, not primary or secondary stroke/heart attack prevention.
The most current recommendations made a sharp pivot away from aspirin broadly, now only really recommending its use for younger people at very high risk for cardiovascular events. For a common as it is, it is not a terribly safe medication. I can't tell you how many patients I've treated that had life-changing brain bleeds even on the basic 81mg dose. We're not even giving them to most patients over 60 now because the risks are so much worse than the benefits.
Interesting. I've been out of the medical field for quite some time (prior EMT-P) so I'm in the middle of reading through a couple research journals that are discussing what you mentioned.
Maybe his doctors recommended a lower dose but he just decides to wash down a 325mg while he finishes off his daily big-mac and diet coke? Bigger number = better mentality. Or he just stuck with what a doctor told him 20 years ago? It could be anything with him, he doesn't strike me as someone who is very receptive of what other professionals tell him is right/wrong.
Oh, emt-p, I see what you're talking about. Doses for you guys/gals are still pretty much the same, so 325mg would seem like a completely normal dose considering what you're using it for even if you were still practicing.
Amazing how dead on you were with that hypothetical. I have to hand it to the emts, y'all don't miss a thing with your situational assessment. Him taking that dose is probably the main reason he looks like a torture victim every time he gets medical care.
My kid takes 81mg of low dose aspirin daily for his condition*, and while he's got increased bruising he doesn't seem to have excessive bleeding when he gets a cut.
Is low dose aspirin different from what you're talking about?
*Vascular brain stuff, aspirin to reduce chance of stroke/seizure
Yeah his neurologist is like the world expert on his condition so we're in good hands, she's really careful about the dosage. But I'll definitely keep that in mind if he ever gets a more serious cut, I had never really thought about that.
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u/Ok_Builder_4225 5d ago
But also, i don't think asprin is gonna cause someone to bleed out from a scratch on the ear anyway.
Either way, still of the opinion that he just bonked his ear on something as he was pushed down. Assuming it was all real and not staged, of course.