Summary
Salicylate intoxication is common. It results in impaired generation of adenosine triphosphate and produces a primary respiratory alkalosis. In adults the clinical manifestations may closely simulate a cerebrovascular event or alcoholic ketoacidosis. Central nervous system dysfunction, fever, glycosuria, ketonuria, respiratory alkalosis with an elevated anion gap, tinnitus, dehydration, hypokalemia and haemostatic defects are common. The diagnosis may be made rapidly by the ferric chloride test or Phenistix® test.
Standard therapy includes gastric emptying, activated charcoal and alkalinisation of the urine. Osmotic diuresis is a controversial measure. Haemodialysis is indicated for patients with serum salicylate levels more than 100 mg/100ml, severe acid-base disturbance, or deterioration despite optimum therapy.
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References
Anderson, R.J.; Potts, D.E.; Gabow, P.A.; Rumack, B.H. and Schrier, R.W.: Unrecognized adult salicylate intoxication. Annals of Internal Medicine 85: 745–748 (1976).
Done, A.K.: Salicylate intoxication: Significance of measurements of salicylate in blood in cases of acute ingestion. Pediatrics 26: 800–807 (1960).
Done, A.K.: Aspirin overdosage: incidence, diagnosis and management. Pediatrics 62(Suppl.): 890–897 (1978).
Done, A.K. and Temple, A.R.: Treatment of salicylate poisoning. Modern Treatment 8: 528–551 (1971).
Freidin, R.B.: Drug overdoses and poisonings; in Cohen et al. (Eds) Medical Emergencies. Diagnostic and Management Procedures from Boston City Hospital pp. 1–32 (Little, Brown and Co., Boston 1977).
Gabow, P.A.; Potts, D.E.; Schrier, R.W. and Anderson, R.J.: The acid-base abnormalities of salicylate intoxication (abstract). Clinical Research 24: 126A (1976).
Goldfrank, L. and Bresnitz, E.: Salicylism. Hospital Physician 14: 50–60 (1976).
Hrnicek, G.; Skelton, J. and Miller, W.C.: Pulmonary edema and salicylate intoxication. Journal of the American Medical Association 230: 866–867 (1974).
Lawson, A.A.H.; Proudfoot, A.T.; Brown, S.S.; Macdonald, R.H.; Fraser, A.G.; Cameron, J.C. and Matthew, H.: Forced diuresis in the treatment of acute salicylate poisoning in adults. Quarterly Journal of Medicine 38: 31–48 (1969).
Levy, G.: Clinical pharmacokinetics of aspirin. Pediatrics 62 (Suppl.): 867–872 (1978).
Myers, E.N.; Bernstein, J.M. and Fostiropolous, G.: Salicylate ototoxicity. A clinical study. New England Journal of Medicine 273: 587–590 (1965).
Temple, A.R.: Pathophysiology of aspirin overdosage toxicity with implications for management. Pediatrics 62 (Suppl.): 873–876 (1978).
Zimmerman, H.J.: Aspirin-induced hepatic injury (Editorial). Annals of Internal Medicine 80: 103–105 (1974).
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Brenner, B.E., Simon, R.R. Management of Salicylate Intoxication. Drugs 24, 335–340 (1982). https://doi.org/10.2165/00003495-198224040-00005
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DOI: https://doi.org/10.2165/00003495-198224040-00005