PLACE LABEL HERE
ASPIRIN DESENSITIZATION
ORDERS
for Aspirin Related Urticaria / Angioedema
The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked.
Initial all handwritten order modifications and the bottom of each page when indicated (multipage).
1.
Unit: Transfer patient to ICU setting and must remain for 2 hrs post completion of this protocol
2.
Assessment/Monitoring: Obtain baseline and document assessment with each new dose
 Observe for hypersensitivity reactions and document if the patient has the following: itching,
rash, wheezing, dyspnea, rhinorrhea
 Blood pressure and pulse
 Oxygen Saturation
3.
Hold beta-blocker dose prior to desensitization to avoid blunting reaction response
4.
Pharmacy Preparation:
Aspirin Suspension Bottle A: (Aspirin 1 mg/ml)
 Crush and dissolve Aspirin 81 mg chewable aspirin tablet into 81 ml tap water
 Label bottle A
Aspirin Suspension Bottle B: (Aspirin 0.1 mg/ml)
 Remove 1 ml from Aspirin suspension Bottle A and add to 9 ml tap water
 Label bottle B
Pharmacy to dispense each dose in a labeled oral syringe
5.
Aspirin Desensitization Dosing:
 81 mg
 162 mg
 325 mg
(see dose chart below to achieve aspirin dose goal)
Goal dose depends on Aspirin dose that patient is expected to take long term.
Goal Aspirin Oral dose
Dose 1
Dose 2
Dose 3
Dose 4
Dose 5
Dose 6
Dose 7
Dose 8
**Dose 9
**Dose 10
0 minutes
20 min
40 min
60 min
80 min
100 min
120 min
140 min
160 min
180 min
0.1 mg
0.3 mg
1 mg
3 mg
10 mg
30 mg
40 mg
81 mg
162 mg
325 mg
Give 1 ml
po of
Bottle B
Give 3 ml
po of
Bottle B
Give 1 ml
po of
Bottle A
Give 3 ml
po of
Bottle A
Give 10 ml
po of
Bottle A
Give 30 ml
po of
Bottle A
Give 40 ml
po of
Bottle A
Give 81 mg
chewable
tablet po
Give 2 x
81 mg
chewable
tablets po
Give 4 x
81 mg
chewable
tablets po
** Optional doses that may be administered, depends on goal Aspirin dose
PRN MEDICATIONS:
6.
Anaphylaxis: Epinephrine 0.3-0.5 ml, 1:1000 (1 mg/ml) solution IM q 5 min prn in absence of
clinical improvement
ADDITIONAL ORDERS:
7.
Notify physician if patient develops signs of allergic reaction
______________
Date
______________
Time
*1-38389*
________________________________
Physician Signature
FORM 1-38389 INITIATED 05/2015
___________
PID Number
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