Aspirin Overdose or Salicylate Poisoning

Posted by e-Medical PPT Thursday, September 23, 2010
Aspirin overdose or salicylate poisoning can be acute or chronic.Acute overdose has a mortality rate of 2%. Chronic overdose is more commonly lethal with a mortality rate of 25%; chronic overdose may be especially severe in children.Patients with mild intoxication frequently have nausea and vomiting, abdominal pain, lethargy, tinnitus, and dizziness. More significant symptoms occur in more severe poisonings and include hyperthermia, tachypnea, respiratory alkalosis, metabolic acidosis, hypokalemia, hypoglycemia, hallucinations, confusion, seizure, cerebral edema, and coma. The most common cause of death following an aspirin overdose is cardiopulmonary arrest usually due to pulmonary edema.
The acutely toxic dose of aspirin is generally considered greater than 150 mg per kg of body mass.Monitoring of biochemical parameters such as electrolytes, liver and kidney function, urinalysis, and complete blood count is undertaken along with frequent checking of salicylate and blood sugar levels. Arterial blood gas assessments are performed to test for respiratory alkalosis and metabolic acidosis.
Initial treatment of an acute overdose involves resuscitation followed by gastric decontamination by administering activated charcoal, which absorbs the aspirin in the gastrointestinal tract. Sodium bicarbonate is given in a significant aspirin overdose as it enhances elimination of aspirin in the urine.Hemodialysis can be used to enhance the removal of salicylate from the blood.

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