Aspirin Overdose

Question 1

what is aspirin overdose a form of

Answer 1

salicylate poisoning

Question 2

def

Answer 2

ingestion (acute or chronic) of chemicals which are metabolised to salicylate

Question 3

what are characteristic features of salicylate poisoning on bloods and ABG

Answer 3

electrolyte abnormalities

acid-base disturbances

Question 4

what is the most common source of salicylate

Answer 4

aspirin

Question 5

where is aspirin metabolised

Answer 5

GI tract and blood

Question 6

how much aspirin could cause acute toxicity

Answer 6

> 150mg/kg or >6.5g, whichever is less

Question 7

how much aspirin could cause chronic toxicity

Answer 7

repeated high dose aspirin equivalent to 150mg/kg/day

Question 8

what syndrome is associated with aspirin use

Answer 8

Reyes syndrome

Question 9

what is reyes syndrome

Answer 9

disorder causing liver and brain damage

Question 10

how can salicylate poisoning occur

Answer 10

accidental ingestion

attempted suicide

Question 11

who is at risk of toxic salicylate exposure

Answer 11

children and elderly due to improper dosing

Question 12

what is the most common form of salicylate poisoning

Answer 12

aspirin

Question 13

what are common aspirin containing products

Answer 13

anadin

beechams powders

Question 14

what characterises salicylate poisoning

Answer 14

mixed acid base disturbance
electrolyte abnormalities
CNS overdose

Question 15

what is the first sign of salicylate poisoning

Answer 15

hyperpnoea due to salicylate induced stimulation of the respiratory centre

Question 16

what is seen on ABG in early SP

Answer 16

respiratory alkalosis (hyperpnoea)

Question 17

what is seen on ABG in late SP

Answer 17

metabolic acidosis

Question 18

how do salicylates impair energy production

Answer 18

interfere with Krebs cycle causing decreased ATP
uncouples oxidative phosphorylation which results in lactate accumulation and release of energy as heat

leads to increased body temp and sweating

Question 19

risk factors

Answer 19

ingestion of aspirin

children or elderly

Question 20

what are features of SP

Answer 20

presence of RFs

abnormal behaviour or delirium
GI symptoms such as N+V + epigastric pain
systemic symptoms such as fever and sweating
acid-base symptoms such as SOB, tachypnoea, hyperpnoea

CNS defects such as hearing loss or tinnitus, dizziness, movement disorders, asterixis, seizures

Question 21

what investigations should be completed

Answer 21

ABG (for acid base disturbance)

bloods (for serum electrolytes and salicylate levels)

Question 22

how can the anion gap be calculated

Answer 22

Na + K - Cl -HCO3

Question 23

why is an ECG requireed

Answer 23

sinus tachycardia (common)
prolonged corrected QT interval is associated with severe ventricular dysarrythmias

Question 24

what are kussmauls respirations

Answer 24

deep laboured breathing due to severe metabolic acidosis (DKA)

Question 25

what is the mneumonic for SEs of aspirin

Answer 25

ASPIRIN

Asthma
Salicylism (N+V + tinnitus)
Peptic Ulcer Disease
Intestial Blood LOss
Reyes syndrome
Idiosyncracy
Noise (tinnitus)

Question 26

what is salicylism

Answer 26

N+V

tinnitus