Salicylate Overdose Flashcards

1
Q

What is salicylate overdose?

A

It is defined as excessive ingestion of the salicylate drug class

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2
Q

What dose of salicylate is considered to be toxic?

A

> 125mg/kg

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3
Q

What salicylate drug is most commonly overdosed on?

A

Aspirin

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4
Q

What are the seven clincial features of salicylate overdose?

A

Fever > 38

Fatigue

Hyperventilation

Tinnitus

Sweating

Seizures

Coma

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5
Q

What are the two investigations used to diagnose salicylate overdose?

A

Blood Tests

Arterial Blood Gas (ABG)

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6
Q

What are the six blood test results indicative of salicylate overdose?

A

Increased Plasma Salicylate Levels

Increased Potassium Levels

Increased Creatinine Levels

Increased Urea Levels

Hyperglycaemia

Hypoglycaemia

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7
Q

When should plasma salicylate concentration levels be measured following overdose?

A

2 hours > ingestion

Then repeat this every 2 hours until the concentration peaks

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8
Q

What plasma salicylate concentration level is classed as mild toxicity?

A

Peak level = < 300mg/L

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9
Q

What plasma salicylate concentration level is classed as moderate toxicity?

A

Peak Level = 300 - 700 mg/L

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10
Q

What plasma salicylate concentration level is classed as severe toxicity?

A

Peak Level = > 700mg/L

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11
Q

What is the feature of salicylate overdose on ABG?

A

A mixed respiratory alkalosis and metabolic acidosis

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12
Q

Explain the ABG results in salicylate overdoses

A

The early stimulation of the respiratory centres leads to a respiratory alkalosis, whilst later the direct acid effects of the salicylates may lead to metabolic acidosis

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13
Q

What are the three pharmacological management options of salicylate overdoses?

A

Activated Charcoal

IV Sodium Bicarbonate

Haemodialysis

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14
Q

When is activated charcoal used to manage salicylate overdoses?

A

It is recommended in individuals who present within one hour of salicylate overdose

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15
Q

How is activated charcoal used to manage salicylate overdoses?

A

It is used to reduce drug absorption

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16
Q

When is IV sodium bicarbonate used to manage salicylate overdoses?

A

It is the first line management option in salicylate overdoses

17
Q

How is IV sodium bicarbonate used to manage salicylate overdose?

A

It is used to enhance elimination of aspirin in urine through urinary alkalisation

18
Q

In which six circumstances is haemodialysis used to manage salicylate overdose?

A

Plasma Salicylate Concentration > 700mg/L

Metabolic Acidosis Resistant To Treatment

Acute Renal Failure

Pulmonary Oedema

Seizures

Coma