SALSALATE

SALSALATe
(sal'sal-ate)
Artha-G, Mono-Gesic, Salflex, Salsitab
Classifications: analgesic (salicylate); nonsteroidal antiinflammatory drug (nsaid);
Therapeutic: nsaid, analgesic
; disease-modifying antirheumatic drug (dmard)
Prototype: Aspirin
Pregnancy Category: C

Availability

500 mg, 750 mg tablets

Action

Actions similar to those of other salicylates. Clinical studies suggest that salsalate does not produce significant gastric irritation, and it has not been associated with reactions causing asthmatic attacks in susceptible individuals. Unlike aspirin, it does not appear to inhibit platelet aggregation. Its antiinflammatory and analgesic activity may be mediated through inhibition of the prostaglandin synthetase enzyme complex.

Therapeutic Effect

Has analgesic, antiinflammatory, and antirheumatic effects.

Uses

Symptomatic treatment, rheumatoid arthritis, osteoarthritis, and related rheumatic disorders.

Contraindications

Hypersensitivity to salicylates or NSAIDs, especially patients with history of asthma, nasal polyposis, or chronic urticaria; chronic renal insufficiency; peptic ulcer; children <12 y; hemophilia; chickenpox, influenza, tinnitus; pregnancy (category C).

Cautious Use

Liver function impairment; older adults; lactation.

Route & Dosage

Arthritis
Adult: PO 325–3000 mg/d in divided doses (max: 4 g/d)

Administration

Oral
  • Give with a full glass of water or food or milk to reduce GI adverse effects.

Adverse Effects (≥1%)

GI: Nausea, dyspepsia, heartburn, vomiting, diarrhea, risk of GI bleed. Special Senses: Tinnitus, hearing loss (reversible). Body as a Whole: Vertigo, flushing, headache, confusion, hyperventilation, sweating. CNS: Drowsiness.

Diagnostic Test Interference

False-negative results for Clinistix; false-positives for Clinitest.

Interactions

Drug: Aminosalicylic acid increases risk of salicylate toxicity. Ammonium chloride and other acidifying agents decrease renal elimination and increase risk of salicylate toxicity. anticoagulants increase risk of bleeding. oral hypoglycemic agents increase hypoglycemic activity with salsalate doses >2 g/d. carbonic anhydrase inhibitors enhance salicylate toxicity. corticosteroids add to ulcerogenic effects. Methotrexate toxicity is increased. Low doses of salicylates may antagonize uricosuric effects of probenecid and sulfinpyrazone. Herbal: Feverfew, garlic, ginger, ginkgo may increase bleeding potential.

Pharmacokinetics

Absorption: Readily absorbed from small intestine. Peak: 1.5–4 h. Metabolism: Hydrolyzed in liver, GI mucosa, plasma, whole blood, and other tissues. Elimination: In urine. Half-Life: 1 h.

Nursing Implications

Assessment & Drug Effects

  • Symptom relief is gradual (may require 3–4 d to establish steady-state salicylate level).
  • Monitor for adverse GI effects, especially in patient with a history of peptic ulcer disease.

Patient & Family Education

  • Do not to take another salicylate (e.g., aspirin) while on salsalate therapy.
  • Monitor blood glucose for loss of glycemic control in diabetes; drug may induce hypoglycemia when used with sulfonylureas.
  • Report tinnitus, hearing loss, vertigo, rash, or nausea.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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