Which OTC medication would be of most concern to the nurse reviewing Mr. Lewis’s medications?

Which OTC medication would be of most concern to the nurse reviewing Mr. Lewis’s medications?

• A. Aspirin (ASA)
• B. Acetaminophen (Tylenol)
• C. Ibuprofen (Advil, Motrin)
• D. Loratadine (Claritin)

Answer: (A)

Aspirin raises the biggest safety red flag here because of its effect on blood clotting. It irreversibly inhibits an enzyme in platelets, which means platelets can’t clump together to form a clot for the life of the platelet (about 7 to 10 days). That leads to a higher risk of bleeding, especially in the stomach or intestines, in people with a history of ulcers, or in those taking other blood thinners. Because of this, aspirin can cause GI bleed or worsen bleeding during surgery or dental procedures, making it the most concerning OTC in a medication review. Acetaminophen is gentler on the stomach and mainly carries a risk of liver injury if taken in excess or with alcohol or preexisting liver disease. Ibuprofen also poses GI and kidney risks, but its blood-thinning effect is reversible and less likely to cause prolonged bleeding than aspirin. Loratadine is an antihistamine with a relatively safe profile for most people. So, the key issue with aspirin is the persistent impact on bleeding risk, which is why it stands out as the medication of most concern in this scenario.

Aspirin raises the biggest safety red flag here because of its effect on blood clotting. It irreversibly inhibits an enzyme in platelets, which means platelets can’t clump together to form a clot for the life of the platelet (about 7 to 10 days). That leads to a higher risk of bleeding, especially in the stomach or intestines, in people with a history of ulcers, or in those taking other blood thinners. Because of this, aspirin can cause GI bleed or worsen bleeding during surgery or dental procedures, making it the most concerning OTC in a medication review.

Acetaminophen is gentler on the stomach and mainly carries a risk of liver injury if taken in excess or with alcohol or preexisting liver disease. Ibuprofen also poses GI and kidney risks, but its blood-thinning effect is reversible and less likely to cause prolonged bleeding than aspirin. Loratadine is an antihistamine with a relatively safe profile for most people. So, the key issue with aspirin is the persistent impact on bleeding risk, which is why it stands out as the medication of most concern in this scenario.