Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Salicylate
Essentials
- 1
Salicylate pharmacokinetics become complex and alter markedly following overdose.
- 2
Treatment and disposition decisions are made on clinical signs, biochemistry and serum salicylate level trends.
- 3
The aim of therapy is to minimize metabolic and central nervous system toxicity.
- 4
Urinary alkalinization is an effective method of enhanced elimination after salicylate overdose.
- 5
Mechanical ventilation of patients with severe salicylate toxicity can worsen acidosis due to the impeding of patient-generated high minute volumes with salicylate-induced hyperpnoea.
- 6
Chronic salicylate poisoning is an insidious condition, mostly seen in the elderly, manifested by an unexplained metabolic acidosis that may be incorrectly attributed to another medical condition.
Introduction
Salicylate is widely used in a variety of pharmaceutical preparations and over-the-counter herbal products, cough and cold remedies, ointments and topical rubefacients. Salicylate poisoning is an infrequent presentation to Australian emergency departments, due largely to the preference of paracetamol as the analgesic of choice. Acute deliberate self-poisoning with salicylate results in a well-described dose-related constellation of symptoms and signs. Emergency physicians have a number of treatment modalities available to manage this condition.
Chronic salicylate intoxication, in contrast, is more likely in the elderly, with multiple co-morbidities and more commonly requires haemodialysis (HD). Chronic intoxication is associated with significant morbidity and mortality. Children rarely ingest sufficient amounts of aspirin to cause toxicity, but ingestion of small amounts (>5 mL) of topical agents containing methyl salicylate can result in severe toxicity in children <5 years of age. Attention should be given to the quoted units of measurement, standard or SI, to avoid incorrect interpretation of serum drug concentrations.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here