Medical Emergencies in the Dental Office – Part Six

St. Joseph Aspirin

Aspirin aka ASA is the last in our series of essential drugs found in the emergency kit in the dental office.

The purpose of Aspirin is to prevent the aggregation/accumulation of platelets which may lead to a myocardial infarction (damage to the heart muscle). In the last blog on Nitroglycerine, we found that by giving a patient with chest pain, Nitroglycerine, we may be able to prevent a Myocardial Infarction (MI). This is by preventing the formation of a blood clot (platelet aggregation, mentioned previously).

Mode of Action of Aspirin
Aspirin inhibits the action of the cyclooxygenase enzymes which in turn results in a reduction of prostaglandins, prostacyclin’s and thromboxane’s. Prostaglandins and prostacyclins both act to induce fever when ill….ASA will counteract this. Prevention of the formation of thromboxane is of importance during a medical emergency. Thromboxane acts to constrict arteries and promote platelet aggregation. ASA is of utmost importance to prevent a blood clot from forming during the initial stages of cardiac ischemia; otherwise there is a greater likelihood that the ischemia may progress to a true MI. Aspirin has been shown to be beneficial during a brief period of time to prevent damage to the heart muscle.

Contraindications to the use of Aspirin
These include:
1) Aspirin hypersensitivity.
2) Severe asthma.
3) History of significant gastric bleeding.

Aspirin is available in a tablet form ranging from 81 mg (baby ASA) to 650 mg. It is quite common for individuals to take one 81 mg tablet of ASA per day as is prescribed by their doctor…to help prevent blood clots.

For emergency purposes i.e. chest pain related to angina, a minimum of 162 mg is required ‘immediately’ to prevent progression to an MI.

To conclude
Our series on the six essential drugs that are required to be in the emergency kit in the dental office is now complete. Aside from the six discussed, there are also supplementary drugs that are advisable to have in the dentist’s office. I’m hoping to discuss these at one point, but for now we will take a break from this subject…oh, by the way…Happy 2016 everyone!

Yours in good dental health,

Dr. F. Keshavarz Dentistry, Brampton Dentist

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