Aspirin OD Flashcards
How does aspirin come?
300mg tablet
What is an OD amount for aspirin?
OD is > 150mg/kg, severe if >500mg/kg
What is important to ask in history for aspirin OD?
- Amount/preparation of salicylate?
- Intentional or accidental?
- Isolated or mixed?
What may be found in clinical examination of aspirin OD?
- Warm peripheries
- bounding pulse
- Tachypnoea
- hyperventilation
- Cardiac arrhythmia
- Acute pulmonary oedema
What are possible DDx for aspirin OD?
- Paracetamol OD
2. DKA
What can be seen on early presentation for aspirin OD?
- Tinnitus, deafness, dizziness (aspiringing)
- Hyperpnoea (rasp-irin)
- Hyperthermia + sweating (perspiring)
- N&V, diarrhoea
What can be seen on late/server presentation for aspirin OD?
- Low BP and heart block
- Pulmonary oedema
- Low GCS + seizures
What beside investigations are used for aspirin OD?
- ECG
- CBG
- ABG
Why is an ECG done?
monitor arrythmias
Why is a CBG done?
exclude hypgolycaemia or ketoacidosis
Why is ABG done?
- hyperventilation causes initial respiratory alkalosis
2. this progress to high anion gap metabolic acidosis
What lab tests are done for aspirin OD?
- Plasma salicylate concentration
- Plasma paraceamol conc: mixed OD
- FBC
- U+Es
- LFT
- Coagulation
Why are FBC done?
exclude infectious aietology
When is plasma slaicylate conentration done?
at least 2 hours after ingestion, repeat every 2 hours until peak concentration
Why are U+Es done?
hyperkalamia is common
Why are LFTs done?
hepatic dysfunction
Why is coagulation done?
INR and prothrombin time
Why is CT head done?
if patient altered statu
How is an OD daignosed?
classified, according to peak salicylate levels
What is mild toxicity?
<300 mg/L
What is moderate toxicity?
300 to 700 mg/L
What is severe toxicity?
> 700 mg/L
What is the management of aspirin OD?
- NO antidote – mainly supportive
2. Consider ICU admission for moderate to severe admission
How does resp alklaosis turn into met acidosis?
- Directly stimulates respiratory centre in medulla causing hyperventilation, therefore you get this initial respiratory alkalosis
- also uncouples oxidative phosphorylation, which sends the body into anaerobic respiration
- body produces lactic acid sending the respiratory alkalosis, into metabolic acidosis with a high anion gap.
Why is there hyperpnoea and hyperthemia in aspirin OD?
- Hyperpnoea, is caused by the fact that aspirin directly stimulates the respiratory centre in the medulla
- Hyperthermia and sweating is caused by the uncoupling of oxidative phosphorylation, that sends the body into anaerobic respiration
