Salicylate Toxicity

From Anvita Health Wiki

Contents 1 Clinical-manifestations 2 Management 3 More General Terms 4 Additional Terms 5 References

Clinical-manifestations

• initially respiratory alkalosis
• later metabolic acidosis
• CNS disturbance with EEG abnormalities

Management

• activated charcoal 50-100 g if presenting within 1 hour of ingestion; multple doses my be useful
• alkaline diuresis for patients with plasma salicylate levels > 40 mg/dL

• 150 meq (3 ampules) of NaHCO3 in 1 liter of D5W at 10-15 mL/kg/hour until urine flow is achieved
• maintenance 2-3 mL/kg/hour
• monitor urine output, urine pH (target pH=7-8), serum K+
• 40 meq KCl over 4-5 hours

• successful alkaline diuresis requires simultaneous administration of KCl

• do not use acetazolamide (increases CNS salicylate toxicity)

• hyperventilate patients requiring endotracheal intubation
• treat altered mental status with IV glucose (despite normal serum glucose)

More General Terms

• toxicity; poisoning; overdose

Additional Terms

• salicylate

References

1. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009

salicylate toxicity