Salicylate poisoning may cause noncardiogenic pulmonary edema (NCPE) in a few patients. A salicylate level of 35 mg/dL or higher causes increases in both rate (tachypnea) and depth (hyperpnea). Salicylates cause both direct and indirect stimulation of respiration.

Adult patients with acute poisoning usually present with a mixed respiratory alkalosis and metabolic acidosis. Salicylates also interfere with the Krebs cycle, limit production of ATP, and increase lactate production, leading to ketosis and a wide anion-gap metabolic acidosis. Salicylates stimulate the respiratory center, leading to hyperventilation and respiratory alkalosis. Salicylates directly or indirectly affect most organ systems in the body by uncoupling oxidative phosphorylation, inhibiting Krebs cycle enzymes, and inhibiting amino acid synthesis. Salicylate poisoning is manifested clinically by disturbances of several organ systems, including the CNS and the cardiovascular, pulmonary, hepatic, renal, and metabolic systems. At therapeutic doses, salicylic acid is metabolized by the liver and eliminated in 2-3 hours. Salicylic acid is readily absorbed in the stomach and small bowel. Many of these medicines may contain salicylate.Īfter ingestion, acetylsalicylic acid is rapidly converted to salicylic acid, its active moiety. The prevalence of alternative medicines and popularity of herbs and traditional medicine formulae are increasing in North America. The prevalence of aspirin-containing analgesic products makes these agents, found in virtually every household, common sources of both accidental and suicidal ingestion.

Pepto- Bismol, a common antidiarrheal agent, contains 131 mg of salicylate per tablespoon. Salicylates are ubiquitous agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs including topical preparations used for the treatment of pain, warts, and acne.

Aspirin toxicity antidote