Toxicology - Salicylates

Question 1

Aspirin - Toxic Dose

Answer 1

greater than 150 mg/kg
life-threatening - greater than 500 mg/kg

Question 2

Salicylate Overdose - Clinical Effects

Answer 2

tachypnea / hyperpnea
NV, hemorrhagic gastritis
hypoglycorrhachia
tinnitus
altered mental status
hyperpyrexia
tachycardia
seizures
pulmonary edema
hepatic & renal injury

Question 3

Salicylate Overdose Laboratory Manifestations - Acid / Base

Answer 3

early - respiratory alkalosis
middle - mixed metabolic acidosis & respiratory alkalosis
later (preterminal) - metabolic & respiratory acidosis

Question 4

Salicylate Overdose Laboratory Manifestations - Electrolytes

Answer 4

hypo- or hyperglycemia
increased fluid & electrolyte losses
increased anion gap

Question 5

Salicylate Overdose - Urinalysis

Answer 5

positive ketones

Question 6

Chronic Salicylate Overdose - Clinical Effects

Answer 6

NV
tinnitus
dyspnea
hyperthermia
neurologic manifestations
pulmonary edema
increased PT / LFTs

Question 7

Salicylate Overdose - Management

Answer 7

maintain ventilation (do not intubate)
multiple doses of activated charcoal (1 g/kg)
urine alkalization to pH > 7.5
maintain potassium
dextrose 0.5-1 g/kg
hemodialysis
+ symptom management