Salicylate overdose Flashcards
What are 6 features of aspirin (salicylate) poisoning?
- Hyperventilation
- Tinnitus
- Deafness
- Vasodilatation
- Sweating
- Coma - very severe poisoning
Where must aspirin overdose be treated and why?
in hospital: plasma salicylate, pH and electrolytes can be measured
Why may salicylate concentration require repeated measurement?
absorption of aspirin may be slow so plasma-salicylate concentration may continue to rise for several hours
Why is clinical and biochemical assessment very important in additon to measurement of salicyalte levels in aspirin overdose?
plasma-salicylate concentration may not correlate with clinical severity, especially in young and elderly
What dosage of aspirin is considered to be more clinically severe?
plasma salicylate concentration of >500mg/L (3.6 mmol/L) unless evidence of metabolic acidosis
When should activated charcoal be given for salicyalte poisoning?
within 1h of ingesting >125mg/kg of aspirin
What is the typical ABG finding in salicylate poisoning?
initial respiratory alkalosis - stimulates respiratory centres in brain, followed by metabolic acidosis by uncoupling oxidative phosphorylation
What are 4 possible aspects of management of salicylate poisoning?
- Replace fluid losses
- Measure plasma potassium concentration
- IV sodium bicarbonate may be given (if potassium in normal range)
- Haemodialysis if severe
Why must plasma potassium levels be measured before giving sodium bicarbonate in salicylate poisoning?
hypokalaemia may complicate alkalinisation of the urine; goal of sodium bicarbonate excretion is to enhance urinary salicylate excretion