What is the aspirin dose recommended in adult cardiogenic shock?

• A. 324 mg PO (81 mg x 4)
• B. 325 mg PO
• C. 162 mg PO
• D. 81 mg PO

Answer: (A)

In acute settings like cardiogenic shock, aspirin is given as a rapid loading dose to quickly inhibit platelet aggregation. The goal is to achieve a prompt antiplatelet effect by blocking COX-1 in platelets, which reduces thromboxane A2 and helps limit further clot formation. In adults this loading dose is typically 162 to 325 mg, with the practical approach often implemented as about 324 mg delivered by four 81 mg tablets. Chewing the tablets speeds absorption, which is important when perfusion may be compromised in shock. After the loading dose, continue with 81 mg daily if there are no contraindications. The smaller doses (162 mg or 81 mg) aren’t sufficient as a loading dose, while the 325 mg option is equivalent in total dose but the common, readily available method is four 81 mg tablets totaling 324 mg.