when is ok to give ASA to children?

[BAM!]

quick question:

when is it OK to give ASA to children?

i think there's 1 exception where it's indicated but can't remember & can't find it either. 😕

thx

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[Blesbok]

Kawasaki Disease is a notable exception to the rule. I am guessing there are at least one or two others.

 

[WhatUpDoc!]

quick question:

when is it OK to give ASA to children?

i think there's 1 exception where it's indicated but can't remember & can't find it either. 😕

thx

According to either UWorld or Step 2 secrets (can't remember), the only two indications are:
1. Juvenile Rheumatoid Arthritis (no longer first line)
2. Kawasaki Disease

 

[BAM!]

much thanks!

 

[masterofmonkeys]

It's only got relative contraindication as far as I know, for asthma (can precipitate severe asthma attacks in certain people...the same ones who respond to singulair etc) and possible viral illnesses (Reye's Syndrome).

From what I remember, it's 'ok' to give aspirin to children in other situations. And as was mentioned earlier, standard of care for Kawasaki's disease.

 

[TMP-SMX]

There is no reason to give aspirin to a child with any kind of fever when there are alternative drugs that don't run the risk of destroying the liver and causing encephalopathy. (Assuming the fever isn't due to Kawasaki or for some type of clotting disorder). Children get fevers due to viral illnesses a vast majority of the time and that's exactly what you don't want to give them aspirin for.

 

[masterofmonkeys]

There is no reason to give aspirin to a child with any kind of fever when there are alternative drugs that don't run the risk of destroying the liver and causing encephalopathy. (Assuming the fever isn't due to Kawasaki or for some type of clotting disorder). Children get fevers due to viral illnesses a vast majority of the time and that's exactly what you don't want to give them aspirin for.

I 100% agree. My point was that if an 8 year old comes into your office with a sprained ankle from playing soccer, there's no reason not to use aspirin.

 

[dezokitty]

I 100% agree. My point was that if an 8 year old comes into your office with a sprained ankle from playing soccer, there's no reason not to use aspirin.

Except there are a number of other alternatives that could be used before aspirin that don't increase the risk of Reye's syndrome... I would think aspirin would generally be avoided if safer alternatives can be substituted.

 

[Mayhem]

According to either UWorld or Step 2 secrets (can't remember), the only two indications are:
1. Juvenile Rheumatoid Arthritis (no longer first line)
2. Kawasaki Disease

Don't we also do aspirin for Rheumatic Fever, or am I mistaken?

 

[WhatUpDoc!]

Don't we also do aspirin for Rheumatic Fever, or am I mistaken?

ASA and other NSAIDS can be used for the migratory polyarthritis features of ARF so I guess that would be another indication too. 👍

 

[dezokitty]

I think aspirin can also be used as an antiplatelet agent after certain procedures to correct congenital heart defects...

 

[thechad]

My point was that if an 8 year old comes into your office with a sprained ankle from playing soccer, there's no reason not to use aspirin.

There is no reason to prescribe aspirin to a child unless it is explicitly indicated (i.e. kawasaki, etc.) What if the kid was exposed to chicken pox a couple days before or a couple of days after he sees you, and you give him aspirin? Any prosecutor with half a brain will tear you apart, and their expert will do the same. If this is really the way you plan to practice medicine, I wish you good luck (cause you'll need it).

 

[braluk]

I think aspirin can also be used as an antiplatelet agent after certain procedures to correct congenital heart defects...

I thought clopidogrel was the mainstay in such a situation.

 

[masterofmonkeys]

There is no reason to prescribe aspirin to a child unless it is explicitly indicated (i.e. kawasaki, etc.) What if the kid was exposed to chicken pox a couple days before or a couple of days after he sees you, and you give him aspirin? Any prosecutor with half a brain will tear you apart, and their expert will do the same. If this is really the way you plan to practice medicine, I wish you good luck (cause you'll need it).

Way to go buddy. I was actually making the point that just because a relatively rare complication can occur in certain situations with aspirin doesn't mean we should throw it out. The incidence for Reye's syndrome attributable to aspirin use (before we started using it less) is quite significantly less than the incidence of serious side effects of vaccinations. And I'm not talking autism.

 

[SoCuteMD]

I think aspirin can also be used as an antiplatelet agent after certain procedures to correct congenital heart defects...

Yeah, I've seen PICU kids with congential heart defects on it. Don't necessarily always use clopidogrel.

Way to go buddy. I was actually making the point that just because a relatively rare complication can occur in certain situations with aspirin doesn't mean we should throw it out. The incidence for Reye's syndrome attributable to aspirin use (before we started using it less) is quite significantly less than the incidence of serious side effects of vaccinations. And I'm not talking autism.

Say what you want, but it's not used. Any peds attending in the US would tear you a new one if you suggested aspirin for a sprained ankle.