(FDA approved in bold)

• To reduce risk of myocardial infarction (MI), transient ischemic attack (TIA) or ischemic stroke (IS) due to fibrin platelet emboli
  
• Angina (unstable or stable)
  
• Revascularization procedures (coronary artery bypass graft (CABG), angioplasty, and carotid endarterectomy)
  
• Analgesic for mild-moderate pain for relief of headache, muscle aches and pains, toothache, arthritis, menstrual pain
  
• Fever
  
• Rheumatic conditions, such as spondyloarthropathies, rheumatoid arthritis, osteoarthritis, pleurisy associated with systemic lupus erythematosus
  
• Reducing risk of stroke in high-risk populations, such as non-valvular atrial fibrillation, when anticoagulants are contraindicated
  
• Toxemia of pregnancy

• By acetylating cyclo-oxygenase-1 (cox-1), aspirin inhibits synthesis of thromboxane A2, a prostaglandin derivative that is a potent vasoconstrictor and inducer of platelet aggregation
  
• Irreversibly inhibits platelet aggregation even at low doses
  
• At larger doses, interferes with cox-1 and -2 in arterial walls, interfering with prostaglandin production. Counteracts fever by vasodilation of peripheral vessels, allowing dissipation of excess heat

• A single dose of aspirin inhibits platelet aggregation for the life of the platelet (7–10 days). In pain, effective within 1–2 hours

• Continue to use for prevention of MI, IS or TIA, and for pain

• Only reduces risk of MI or IS. Warfarin is superior for cardiogenic stroke. Control all IS risk factors such as smoking, hyperlipidemia, and hypertension. For acute events, admit patients for treatment and diagnostic testing. Consider screening for aspirin resistance

• In stroke prevention, there is no proven benefit to using clopidogrel in combination with aspirin. In clinical trials, there was no significant difference in IS prevention, and AEs (mostly bleeding) were significantly higher
  
• Consider changing to dipyridamole-aspirin combination for IS prevention
  
• Pain: In acute migraine, add caffeine and/or acetaminophen, antiemetics, or triptans

• None required