Aspirin Overdose Flashcards

1
Q

What is an Aspirin overdose?

A

Excessive ingestion of aspirin causing toxicity

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2
Q

Describe the aetiology of Aspirin overdose

A

Can be a result of deliberate self-harm, suicidal intent or by accident

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3
Q

What is the typical SBA clue for Aspirin overdose?

A

PMHx of TIA/ stroke so likely to be on aspirin + depression (OD)

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4
Q

Describe the epidemiology of Aspirin overdose

A

One of the MOST COMMON drug ODs

People at extremes of ages (e.g. < 3yrs or >70yrs) = particular risk of incorrect dosing

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5
Q

List 8 early symptoms of Aspirin overdose

A
Flushed  
Sweating  
Dizziness  
Malaise  
Tinnitus/ Deafness  
N+V  
Haematemesis 
Epigastric pain
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6
Q

List 6 signs of Aspirin overdose

A
Kussmaul's breathing  
Fever  
Tachycardia 
Hyperventilation 
Epigastric tenderness  
Asterixis/ stupor/ movement disorders
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7
Q

What bloods are necessary in Aspirin overdose?

A

Salicylate levels
FBC: WBC elevated but non-specific
U+Es: check for hypokalaemia; urea + cr levels may be deranged if renal insufficiency
LFTs: high AST/ALT due to direct hepatotoxicity
Clotting screen: high PT
Other drug levels (e.g. paracetamol)

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8
Q

Describe what may be seen on ABG in Aspirin overdose

A
Mixed
Respiratory alkalosis (increased resp drive so blow off CO2)
Metabolic acidosis (lactic acid buildup)
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9
Q

What is the treatment for Aspirin overdose?

A

IV fluids

Sodium Bicarbonate

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10
Q

What may be seen on ECG in Aspirin overdose?

A
Signs of hypokalaemia:
Flattened/ inverted T waves
U waves
Prolonged PR interval
ST depression
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11
Q

List 6 late symptoms of Aspirin overdose

A
Lethargy 
Confusion 
Convulsions 
Drowsiness  
Respiratory depression  
Coma
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12
Q

What key facts should be established about the aspirin overdose?

A

How much aspirin was taken?
When was it taken?
Were any other drugs taken?
Have you had any alcohol?

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13
Q

Describe levels of Aspirin causative of toxicity

A
10-20 g can cause moderate-severe toxicity in adults  
150mg/kg: mild toxicity 
250mg/kg: moderate 
>500mg/kg: severe 
>700mg/kg: potentially fatal
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14
Q

Describe the pathophysiology of Aspirin overdose

A

Increases RR + depth by stimulating the respiratory centre
Hyperventilation –> respiratory alkalosis (early stage)
Body compensates by increasing urinary bicarbonate + K+ excretion
Leads to dehydration + hypokalaemia
Loss of bicarbonate, uncoupling of mitochondrial oxidative phosphorylation + the build up of lactic acid can lead to metabolic acidosis
In SEVERE cases, CNS depression + respiratory failure can occur

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15
Q

Describe the physiological properties of Aspirin and its absorption

A

Aspirin is a weak acid with poor water solubility

Is rapidly hydrolysed to salicylate in GIT + bloodstream

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