Management of Drug Poisoning: Salicylate Toxicity

Introduction

Salicylate poisoning occurs due to excessive ingestion of salicylates, commonly found in aspirin and other medications. This condition can be life-threatening, requiring prompt diagnosis and intervention.

Pathophysiology

Salicylates disrupt cellular metabolism, leading to metabolic acidosis and respiratory alkalosis. They also affect the central nervous system, increasing oxygen consumption and causing hyperthermia.

Clinical Presentation

Early symptoms: Nausea, vomiting, tinnitus
Progressive symptoms: Hyperventilation, confusion, seizures
Severe toxicity: Coma, cardiovascular collapse

Laboratory Findings

Diagnosis involves measuring serum salicylate levels. Other findings include metabolic acidosis, elevated anion gap, and respiratory alkalosis.

Treatment Strategies

Supportive care: Airway protection, oxygen therapy
Decontamination: Activated charcoal administration
Enhanced elimination: Alkalinization with sodium bicarbonate
Hemodialysis: Considered for severe cases

Conclusion

Early recognition and appropriate management of salicylate poisoning are crucial to prevent morbidity and mortality. Physicians must remain vigilant when treating suspected cases.