L5: Salicylates

Question 1

what are Salicylates?

Answer 1

Salicylates are salts or esters of salicylic acid.

Question 2

Forms of Salicylates in nature

Answer 2

Some derivatives are found in nature like methyl salicylate.

Question 3

Common Preparations of Salicylates

Answer 3

• Acetyl salicylic acid (aspirin)
• Methyl-salicylate (oil of wintergreen)

Question 3

Acetyl Salicylic acid (Aspirin)

Answer 3

• Available as lablets ranging from 75 mg for children to 325 mg for adults.

Question 4

Methyl-Salicylate (Oil of wintergreen)

Answer 4

• It is a colorless or yellowish liquid which has a characteristic odor and taste.
• It is the most dangerous of salicylate formulations as one teaspoonful contains 7000 mg of salicylate.

Question 4

Toxic action of Salicylates

Answer 4

• Local action
• Systemic action

Question 5

Local toxic action of Salicylates

Answer 5

• Gastro-intestinal irritation
• Flaring up of peptic ulcer symptoms.

Question 6

Systemic toxic action of Salicylates

Answer 6

• CNS effects
• Metabolic effects
• Hematological effects
• Hyperthermic effects
• Allergic effects

Question 7

CNS effects of Salicylates

Answer 7

Question 8

How do Salicylates Cause respiratory stimulation?

Answer 8

• Direct action on the brain.
• Indirect action by enhancing o2 consumption & cellular metabolic rate

Question 9

what does resp. stimulation by Salicylates lead to?

Answer 9

• CO2 accumulation → hyperventilation → decreased PCO2 (respiratory alkalosis) → renal compensation by excreting more HCO3 and retaining more H+

Question 10

Metabolic effects of Salicylates

Answer 10

Question 11

Heamtologic effects of Salicylates

Answer 11

Question 12

How do Salicylates decreases plasma prothrombin time?

Answer 12

• Direct hepatoloxicity, interfering with Vit.K utilization & inhibition of fact. VIl synthesis .
• Aspirin is transformed into dicoumarol which competes with Vit. K resulting in hypoprothrombinemia.

Question 13

what causes Hyperthermic effects of Salicylates?

Answer 13

Due.to

• Enhancement of 02 consumption
• Cellular metabolic rate
• Dissociation of oxidative phosphorylation.

Question 13

Allergic effects of Salicylates

Answer 13

• Skin rashes
• Hypersensitivity reactions
• Bronchospasm
• Angionerotic oedema
• Anaphylactic shock.

Question 14

manner of poisoning by Salicylates

Answer 14

Question 15

CP of Salicylates Toxicity

Answer 15

Acute or Chronic

Question 16

CP of Mild Salicylate Toxicity

Answer 16

Question 17

CP of Moderate Salicylate Toxicity

Answer 17

Question 18

CP of Severe Salicylate Toxicity

Answer 18

Question 19

Lethal Salicylate Toxicity

Answer 19

Coma & Death

Question 20

what causes Chronic Salicylate Poisoning?

Answer 20

results from ingestion or application of large doses for long periods.

Question 21

CP of Chronic Salicylate Poisoning

Answer 21

• Tinnitus
• Abnormal bleeding (gastric or retinal)
• Gastric ulceration
• Weight loss
• Mental deterioration
• Skin eruption
• May be liver damage

Question 22

Investigations for **Salicylate Toxicity**

Answer 22

Question 23

TTT aspects of **Salicylate Toxicity**

Answer 23

- Emergency and supportive measures - Decontamination - Antidote - Enhanced elimination

Question 24

emergency and supportive treatment of **Salicylate Toxicity**

Answer 24

Core of Airway, Breathing & Circulation.

Question 25

Decontaminatio of **Salicylate Toxicity**

Answer 25

- Activated Charcoal - Gastric Lavage - Cothartic

Question 26

Activated charcoal in **Salicylate Toxicity**

Answer 26

- Administration of activated charcoal to adsorb any remaining drvg.

Question 26

Gastric Lavage of **Salicylate Toxicity**

Answer 26

- Gastric lavage using saline or water. - It may be effective up to 12 hours.

Question 27

Cathartic in **Salicylate Toxicity**

Answer 27

A saline cathartic may be given to hasten passage through the G.I.T

Question 27

antidote in **Salicylate Toxicity**

Answer 27

- No specific antidote. - NaHCO3 is given to prevent acidemia and promote elimination.

Question 28

Enhanced Elimination of **Salicylate**

Answer 28

- Alkaline Diuresis - Multiple Doses Activated Charcoal - Hemodialysis - Charcoal Haemoperfusion and MDAC

Question 29

Alkaline diuresis of **Salicylate Toxicity**

Answer 29

- Correction of acidosis and alkalinization of urine with administration of sodium bicarbonate.

Question 29

When is Alkaline diuresis of **Salicylate Toxicity** contraindicated?

Answer 29

* Pulmonary oedema, * Impaired renal function * Shock.

Question 30

Multiple doses of activated charcoal for enhanced elimination

Answer 30

- To adsorb any remaining drug in stomach - Interrupt entero-entric and entero-hepatic circulation

Question 31

Hemodialysis **Salicylates Toxicity**

Answer 31

It effectively increases the clearance and improves fluid electrolyte balance. It is indicated in - Severe toxicity - Cases of cardiac or renal failure.

Question 32

Charcoal Hemoperfusion & MDAC in Alkaline diuresis of **Salicylate Toxicity**

Answer 32

They produce better salicylate clearance than haemodialysis.

Question 33

Symptomatic Treatment in **Salicylate Toxicity**

Answer 33