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1. Kaiser Permanente National Aspirin Clinician Guide

Kaiser Permanente National Aspirin Clinician Guide This Clinician Guide expires within two years of the posted month. 1 See National Clinical Library for current version (https://cl.kp.org). Aspirin Clinician Guide October 2018 Introduction These recommendations were developed to assist primary care physicians and other clinicians in aspirin use. The KP National Integrated Cardiovascular Health Guideline team adopted the 2016 aspirin recommendations developed by the United States Preventive (...) Services Task Force (USPSTF) on “Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication” for patients without Atherosclerotic Cardiovascular Disease (ASCVD). It is not intended or designed as a substitute for the reasonable exercise of independent clinical judgment by practitioners. Aspirin Therapy at 81 mg Orally Daily for Adults without ASCVD Risk Assessment ? 10-year ASCVD Risk is risk of fatal or nonfatal myocardial infarctions or strokes in adults. A region may

2019 Kaiser Permanente National Guideline Program

2. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer

Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer 1 Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer Interim Guidance from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group October 5, 2018 Three randomized clinical trials (ARRIVE 1 , ASCEND 2 , and ASPREE 3 ) recently published results on aspirin use in patients without known Atherosclerotic Cardiovascular Disease (ASCVD). The studies looked at benefits including (...) cardiovascular event prevention, and risks including serious bleeding events. Overall the studies suggest that aspirin lacks net benefit (total benefits minus total harms) beyond age 70, and there is low net benefit in younger adults. USPSTF 2016 aspirin recommendations point to highest net benefit for aspirin in adults age 50-59 (lower bleeding risk than older patients) with 10-year ASCVD risk* >10%. The National Kaiser Permanente Aspirin recommendations will be formally updated following a comprehensive

2019 Kaiser Permanente National Guideline Program

3. Low-Dose Aspirin Use During Pregnancy

Low-Dose Aspirin Use During Pregnancy ACOGCOMMITTEEOPINION Number 743 Committee on Obstetric Practice Society for Maternal–Fetal Medicine This Committee Opinion was developed by the Committee on Obstetric Practice in collaboration with committee member T. Flint Porter, MD, and the Society for Maternal–Fetal Medicine in collaboration with members Cynthia Gyamfi-Bannerman, MD, MS, and Tracy Manuck, MD. Low-Dose Aspirin Use During Pregnancy ABSTRACT: Low-dose aspirin has been used during pregnancy (...) , although the list of indications for low-dose aspirin use was more expansive. Daily low-dose aspirin use in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use. The AmericanCollege of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the U.S. Preventive Services Task Force guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended

2018 American College of Obstetricians and Gynecologists

4. Low-Dose Aspirin Use During Pregnancy

Low-Dose Aspirin Use During Pregnancy ACOGCOMMITTEEOPINION Number 743 Committee on Obstetric Practice Society for Maternal–Fetal Medicine This Committee Opinion was developed by the Committee on Obstetric Practice in collaboration with committee member T. Flint Porter, MD, and the Society for Maternal–Fetal Medicine in collaboration with members Cynthia Gyamfi-Bannerman, MD, MS, and Tracy Manuck, MD. Low-Dose Aspirin Use During Pregnancy ABSTRACT: Low-dose aspirin has been used during pregnancy (...) , although the list of indications for low-dose aspirin use was more expansive. Daily low-dose aspirin use in pregnancy is considered safe and is associated with a low likelihood of serious maternal, or fetal complications, or both, related to use. The AmericanCollege of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the U.S. Preventive Services Task Force guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended

2018 American College of Obstetricians and Gynecologists

5. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication

Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication Final Update Summary: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication Release Date: April 2016 Recommendation (...) Summary Population Recommendation Grade Adults aged 50 to 59 years with a ≥10% 10-year CVD risk The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years. Adults aged 60 to 69 years with a ≥10

2016 U.S. Preventive Services Task Force

6. Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication

Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication Final Update Summary: Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive Medication - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: Preventive (...) Medication Release Date: September 2014 Recommendation Summary Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia Population Recommendation Grade Pregnant Women Who Are At High Risk for Preeclampsia The USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia. ( ) Related Information for Consumers Related Information for Health Professionals There is no related information

2014 U.S. Preventive Services Task Force

7. Colorectal cancer

(including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. 1.1 1.1 Prevention Prevention of colorectal cancer in people with of colorectal cancer in people with Lynch syndrome Lynch syndrome 1.1.1 Consider daily aspirin [1] , to be taken for more than 2 years, to prevent colorectal cancer in people with Lynch syndrome. T o find out why the committee made the recommendation on prevention of colorectal cancer in people with Lynch (...) early rectal cancer is defined as cT1-2, cN0, M0. cTNM refers to clinical classification based on evidence acquired before treatment, for example imaging, physical examination and endoscopy. pTNM refers to pathological classification based on histopathology. [1] At the time of publication (January 2020), aspirin does not have a UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

8. Hypertension in pregnancy: diagnosis and management

-eclampsia. [2010, amended 2019] [2010, amended 2019] Antiplatelet agents Antiplatelet agents 1.1.2 Advise pregnant women at high risk of pre-eclampsia to take 75–150 mg of aspirin [1] daily from 12 weeks until the birth of the baby. Women at high risk are those with any of the following: hypertensive disease during a previous pregnancy chronic kidney disease autoimmune disease such as systemic lupus erythematosus or antiphospholipid Hypertension in pregnancy: diagnosis and management (NG133) © NICE 2019 (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 54syndrome type 1 or type 2 diabetes chronic hypertension. [2010, amended 2019] [2010, amended 2019] 1.1.3 Advise pregnant women with more than 1 moderate risk factor for pre- eclampsia to take 75–150 mg of aspirin [1] daily from 12 weeks until the birth of the baby. Factors indicating moderate risk are: first pregnancy age 40 years or older pregnancy interval of more than

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

9. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

1.7 Optimal positioning and early mobilisation for people with acute stroke 16 1.8 Avoiding aspiration pneumonia 17 1.9 Surgery for people with acute stroke 17 T erms used in this guideline 18 Recommendations for research 21 Key recommendations for research 21 Rationale and impact 22 Initial management of suspected and confirmed transient ischaemic attack (aspirin) 22 Initial management of suspected and confirmed transient ischaemic attack 22 Imaging for people who have had a suspected TIA (...) to the emergency department with a suspected stroke or TIA, establish the diagnosis rapidly using a validated tool, such as ROSIER (Recognition of Stroke in the Emergency Room). [2008] [2008] Initial management of suspected and confirmed TIA Initial management of suspected and confirmed TIA 1.1.4 Offer aspirin (300 mg daily), unless contraindicated, to people who have had a suspected TIA, to be started immediately. [2019] [2019] 1.1.5 Refer immediately people who have had a suspected TIA for specialist

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

10. Twin and triplet pregnancy

on antenatal care for uncomplicated pregnancies. [2011] [2011] 1.6.2 Advise women with a twin or triplet pregnancy to take low-dose aspirin [1] daily from 12 weeks until the birth of the babies if they have 2 or more of the risk factors specified in NICE's guideline on hypertension in pregnancy. [2011, [2011, amended 2019] amended 2019] Twin and triplet pregnancy (NG137) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 20

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

11. Dementia: assessment, management and support for people living with dementia and their carers

-steroidal anti-inflammatory drugs (NSAIDs), including aspirin. Pharmacological management of non-Alzheimer's dementia Pharmacological management of non-Alzheimer's dementia 1.5.10 Offer donepezil or rivastigmine to people with mild to moderate dementia with Lewy bodies. [1] 1.5.11 Only consider galantamine [2] for people with mild to moderate dementia with Lewy bodies if donepezil and rivastigmine [1] are not tolerated. 1.5.12 Consider donepezil or rivastigmine for people with severe dementia with Lewy

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

12. Rheumatoid arthritis in adults: management

, including age and pregnancy. [2018] [2018] 1.6.2 When treating symptoms of RA with oral NSAIDs: offer the lowest effective dose for the shortest possible time offer a proton pump inhibitor (PPI), and and review risk factors for adverse events regularly. [2018] [2018] 1.6.3 If a person with RA needs to take low-dose aspirin, healthcare professionals should consider other treatments before adding an NSAID (with a PPI) if pain relief is ineffective or insufficient. [2009, amended 2018] [2009, amended 2018

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

13. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

for people who are obese 35 Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism (NG89) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 413 Direct oral anticoagulants for people with lower limb immobilisation 36 4 Aspirin prophylaxis for people with fragility fractures of the pelvis, hip or proximal femur 37 5 Duration of prophylaxis for elective total (...) 2018] Pharmacological proph Pharmacological prophylaxis ylaxis 1.3.12 For pharmacological VTE prophylaxis in people under 18, follow the recommendations on apixaban, aspirin, dabigatran etexilate, fondaparinux sodium, low-molecular-weight heparin (LMWH) and rivaroxaban in this guideline. At the time of publication (March 2018), these drugs did not have a UK marketing authorisation for use in young people under 18 for this indication. The prescriber should follow relevant professional guidance

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

14. Sore throat (acute): antimicrobial prescribing

medicines, unless otherwise stated. 3 Erythromycin is preferred in young women who are pregnant. See the evidence and committee discussion on choice of antibiotic and antibiotic course length. Sore throat (acute): antimicrobial prescribing (NG84) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 9 of 24Summary of the e Summary of the evidence vidence Self-care Or Oral analgesia al analgesia Overall aspirin, paracetamol (...) and diclofenac potassium (not available to buy over the counter) were all more effective than placebo at reducing pain and fever in adults with sore throat associated with an upper respiratory tract infection. This was based on low to moderate quality evidence from 3 randomised controlled trials (RCTs) (Eccles et al. 2003, Gehanno et al. 2003 and Voelker et al. 2016). Overall, adverse events for aspirin, paracetamol and diclofenac potassium in the 3 RCTs did not appear to be significantly different from

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

15. Kidney Pre-biopsy medication: Antiplatelet and anticoagulant agents

MacGinley. GUIDELINES a. We recommend continuation of aspirin in patients at high risk for a cardiovascular event, including those with a history of coronary stent (particularly within 3 months of bare metal stent or 12 months of drug eluting stent insertion), symptomatic myocardial ischaemia or peripheral vascular disease (including patients with a peripheral stent), or previous ischaemic stroke (1C). b. We recommend cessation of aspirin for patients at low risk for a cardiovascular event either 3 days (...) and are not covered by this guideline. To minimise the risk of bleeding, the practice of advising patients to stop antiplatelet and anticoagulant agents prior to renal biopsy is common. These agents are common in patients with kidney disease, who are at increased risk of vascular disease. The most frequently prescribed antiplatelet agents include cyclooxygenase inhibitors (e.g. aspirin) and adenosine diphosphate (ADP) receptor inhibitors (e.g. clopidogrel, ticlopidine, prasugrel). Aspirin irreversibly inhibits

2020 KHA-CARI Guidelines

16. Recommendations for good practice in Ultrasound: Oocyte retrieval Full Text available with Trip Pro

and take actions to prevent any possible associated complications. Patients should at least be asked about the use of medications—more specifically the use of blood thinning agents (aspirin and others), relevant previous surgeries and any relevant disease or deficit of coagulation factors. Information provision and informed consent – Recent or confirmation of (written) informed consent for treatment should be obtained according to local regulations. Verbal and written information should be provided

2020 European Society of Human Reproduction and Embryology

17. Dual vs single antiplatelet therapy Full Text available with Trip Pro

Dual vs single antiplatelet therapy Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline | The BMJ Intended for healthcare professionals Username * Password * Edition: Search form Search Search Dual antiplatelet... Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline (Published 18 (...) December 2018) Cite this as: BMJ 2018;363:k5130 Recommendation 1: Dual vs single antiplatelet therapy or or Dual antiplatelet therapy Single agent therapy Aspirin and clopidogrel All identified trials compared with aspirin alone Patients that have experienced: High risk transient ischaemic attack (TIA) Minor ischaemic stroke Interventions compared Recommendation Population ASA CLOP + ASA A score of 3 or less on the National Institutes of Health Stroke Scale (NIHSS), and no persistent disabling

2018 BMJ Rapid Recommendations

19. Kaiser Permanente National Adult Blood Pressure Clinician Guide

, typically found in 12 oz of regular beer (approximately 5% alcohol), 5 oz of wine (approximately 12% alcohol), and 1.5 oz of distilled spirits (approximately 40% alcohol). } To further promote vascular health, follow KP Guidelines to treat cholesterol and diabetes mellitus, recommend aspirin use, and promote tobacco cessation. } Encourage adherence to medications and monitoring. Help overcome barriers. • Once-daily and combination pills can help minimize pill burden (number of daily pills needed

2019 Kaiser Permanente National Guideline Program

20. Iron deficiency anaemia in adults

and a comprehensive list will allow identification of any type of medicine that might cause gastrointestinal bleeding (bleeding from the stomach and intestines), such as ibuprofen or aspirin. Menstrual pattern Particularly heavy or prolonged periods can lead to anaemia, but this may go unreported if the patient has always had periods of this kind and has not seen a marked difference in what they are used to. Establishing an idea of volume of loss and length of bleeding in days, as well as what is a normal pattern

2019 Royal College of Nursing

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