Aspirin Overdose Flashcards
Define aspirin overdose.
Potentially fatal poisoning occurring as a result of ingestion or, rarely, topical exposure to salicylates. Can present acutely or indolently with more chronic exposure.
Explain the aetiology/risk factors of aspirin overdose.
The most common source of salicylate poisoning is aspirin (acetylsalicylic acid), which is rapidly hydrolysed to salicylate in the gastrointestinal tract and bloodstream.
Summarise the epidemiology of aspirin overdose.
In the UK, deaths by suicidal overdose of analgesics, including salicylates, were reduced by 22% in the year immediately after the introduction in 1998 of legislation limiting the pack size of analgesics that could be purchased.
Recognise the presenting symptoms of aspirin overdose. Recognise the signs of aspirin overdose on physical examination.
Nausea, vomiting, haematemesis, epigastric pain
Fever and diaphoresis
Shortness of breath
Tachypnoea, hyperpnoea, Kussmaul’s respirations
Tinnitus and/or deafness
Malaise and/or dizziness
Movement disorders, asterixis, stupor
Confusion and/or delirium (irritability, hallucinations)
Coma and/or papilloedema
Seizures
Identify appropriate investigations for aspirin overdose and interpret the results.
ABG
Serum electrolyte panel
Serum salicylate level
Serum urea and creatinine
Serum ketones
Blood glucose
FBC
Serum LFTs
Serum PT, activated PTT, INR
Toxicology screen
CXR
ECG
Generate a management plan for aspirin overdose.
IV bicarbonate
Haemodialysis
50g activated charcoal
Identify the possible complications of aspirin overdose and its management.
- Acute respiratory distress syndrome
- Cardiac arrest
- Seizures
- Drug-induced hepatitis
Summarise the prognosis for patients with aspirin overdose.
Most adult deaths occur in patients whose concentrations exceed 700 mg/L (5.1 mmol/L). Patients are more likely to die if they are aged over 70 years, or if they develop coma, convulsions, confusion, agitation, hyperpyrexia, pulmonary oedema, or metabolic acidosis.
