Practice name
Address
State, City, Zip
Phone: Fax:
E-mail:
Name: __________________________________________ Date:____________________________
ASA Challenge
Angioedema/Urticaria/asthma with or without anaphylaxis
The patient needs to avoid H1 antihistamines and Cromolyn. If necessary can treat with steroids for the
asthma. There is risk with this procedure as the patient can have hives, respiratory problems, or
anaphylaxis. The patient must be watch carefully with serial vital signs and pulmonary function testing
Obtain Baseline Spirometry and Final Spirometry unless reduced Peak Flow or respiratory symptoms
develop during testing, then repeat more often.
Time: 2 ½-3 hours minimum
ASA 81 mg. Plan to add 10 cc water and dissolve completely. This makes approximately 10 mg/cc
dilution. Then take 1 cc of this preparation and add 9 cc water. This makes a 1 mg/cc solution.
Protocol
Dose
Time
Administered
Pulse
Resp
BP
Skin exam + any other
symptoms, signs
Baseline values
ASA 1 mg, wait 30
minutes
ASA 10 mg, wait 30
min.
ASA 81 mg wait 30
minutes
ASA 165 mg, ½ of an
adult 325 mg tablet
30 minutes
ASA 325 mg tablet,
wait 45 minutes
Notes:----------------------------------------------------------------------------------------------- ------------------
Final Diagnosis:__________________________________________________
Directions after discharge:_____________________________________________
Spiro completed
list time