Aspirin is contraindicated in dengue because?

SGPGI Nursing Officer-2023

Pharmacology

Medium

Appeared in: SGPGI Nursing Officer-2023

Explanation

Dengue fever is characterized by thrombocytopenia (low platelet count), which increases the risk of bleeding.
Aspirin is an anti-platelet agent that works by irreversibly inhibiting the COX-1 enzyme, thereby preventing the synthesis of Thromboxane A₂, which is essential for platelet aggregation.
Administering aspirin to a dengue patient compounds the bleeding risk by impairing the function of the already reduced number of platelets.
This dual effect—low platelet count from dengue and impaired platelet function from aspirin—can lead to severe hemorrhagic complications.

Option B: While aspirin does increase the chance of GIT bleeding, this is a consequence of its anti-platelet effect and direct irritation of the gastric mucosa. The primary, systemic reason for its contraindication in dengue is its effect on platelet function, which poses a risk of bleeding throughout the body, not just the GIT.
Option C: Aspirin's painkiller (analgesic) action is a therapeutic effect, not the reason for its contraindication. Other safer painkillers, like paracetamol, are recommended in dengue.
Option D: This statement is factually incorrect. Aspirin has an anti-clotting (anti-platelet and anticoagulant at high doses) action; it does not promote blood clotting.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological contraindications in infectious diseases, specifically the use of aspirin in dengue fever as background academic context rather than a clinical decision trigger.
A core nursing responsibility is medication safety. Nurses must know the contraindications of common over-the-counter drugs like aspirin, especially in the context of prevalent infectious diseases like dengue.
Patient education is critical. Nurses must instruct patients and their families to avoid aspirin and other NSAIDs for fever or pain if dengue is suspected, and to use paracetamol instead.
Nurses should monitor for signs of bleeding in dengue patients, such as petechiae, purpura, gum bleeding, or melena, and report them immediately. This vigilance is even more critical if a patient has inadvertently taken an NSAID.

How to Approach the Question

First, identify the two key concepts in the question: the drug (Aspirin) and the disease (dengue).
Recall the primary pathophysiology of dengue fever, specifically its effect on blood components. The key feature is thrombocytopenia (low platelets).
Recall the primary mechanism of action of aspirin, particularly its effect on blood. The key feature is its anti-platelet activity.
Connect the two concepts: How would an anti-platelet drug affect a patient who already has a low platelet count and is at risk for bleeding?
Evaluate the options based on this connection. The most direct and significant interaction is the exacerbation of bleeding risk due to aspirin's anti-platelet effect on a patient with dengue-induced thrombocytopenia.

Concept Tested & Keywords

Concept Tested: Pharmacological contraindications in infectious diseases, specifically the use of aspirin in dengue fever.
Stem keywords: Aspirin, contraindicated, dengue
Lead-in keywords: because
Negative lead-in flag: false

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