Aspirin Poisoning - Aspirin Poisoning - Merck Manual Consumer Version (2024)

FAQs

What is the drug of choice for aspirin poisoning? ›

The diagnosis is based on blood tests and the person's symptoms. Treatment involves giving activated charcoal by mouth or stomach tube, giving fluids and bicarbonate by vein, and, for severe poisoning, undergoing hemodialysis.

In addition to alkalinizing the bloodstream, sodium bicarbonate helps to alkalinize the urine and promote aspirin elimination by the kidney. Monitor urine pH carefully and try to achieve urine pH 7-8. Hypokalemia will inhibit the ability to alkalinize urine; potassium supplementation is typically necessary.

No specific antidote for salicylate poisoning is available. Therapy focuses on immediate resuscitation, correction of volume depletion and metabolic derangement, GI tract decontamination, and reduction of the body's salicylate burden.

Later, if poisoning is severe, the person can develop light-headedness, fever, drowsiness, hyperactivity, confusion, seizures, destroyed muscle tissue (rhabdomyolysis), kidney failure, and difficulty breathing.

Other medicines may be given through a vein, including potassium salt and sodium bicarbonate, which helps the body remove aspirin that has already been absorbed. If these treatments do not work or the overdose is extremely severe, hemodialysis (kidney machine) may be needed to reverse the condition.

Treatment of Salicylate Poisoning

After volume and electrolyte abnormalities are corrected, alkaline diuresis can be used to increase urine pH, ideally to ≥ 8. Alkaline diuresis is indicated for patients with any symptoms of poisoning and should not be delayed until salicylate levels are determined.

With chronic overdose, symptoms and signs tend to be nonspecific, vary greatly, and may suggest sepsis. They include subtle confusion, changes in mental status, fever, hypoxia, noncardiogenic pulmonary edema, dehydration, lactic acidosis, and hypotension.

Nausea, vomiting, diaphoresis, and tinnitus are the earliest signs and symptoms of salicylate toxicity. Other early symptoms and signs are vertigo, hyperventilation, tachycardia, and hyperactivity. As toxicity progresses, agitation, delirium, hallucinations, convulsions, lethargy, and stupor may occur.

The antihemostatic effect of aspirin and other antiplatelet strategies can be corrected by the administration of platelet concentrate and/or desmopressin.

How long does aspirin stay in your system? ›

If you decide to stop, make sure you are staying well hydrated and do not get dehydrated. Aspirin has a very long half life. No point stopping a day or 2 before. The half life is 5 days, so after 10 days you still have 25% of the power of Aspirin left in your blood.

The synthesis of aspirin is an esterification reaction. Esterification is the general name for a chemical reaction in which two chemicals (typically an alcohol and an acid) form an ester as the reaction product (aspirin). Esterification is a reversible reaction.

The onset of liver injury was within a few days of starting high doses of aspirin. The patient was mildly symptomatic but not jaundiced. There were also changes in alkaline phosphatase levels. Toxicity appeared to correlate with serum salicylate levels.

The earliest symptoms of acute aspirin poisoning may include ringing in the ears (tinnitus) and impaired hearing. More clinically significant signs and symptoms may include rapid breathing (hyperventilation), vomiting, dehydration, fever, double vision, and feeling faint.

Aspirin can cause ulcers in your stomach or gut, especially if you take it for a long time or in big doses. Your doctor may tell you not to take aspirin if you have a stomach ulcer, or if you've had one in the past.

The antiplatelet effect of aspirin can be readily reversed with platelet transfusions because aspirin is cleared from the circulation within an hour of ingestion.

Aspirin is in a group of medications called salicylates. It works by stopping the production of certain natural substances that cause fever, pain, swelling, and blood clots. Aspirin is also available in combination with other medications such as antacids, pain relievers, and cough and cold medications.

Antidotes. An antidote is a medication that neutralizes or counteracts the effects of a poison in the body. Not all toxins have an antidote but those that do include medications such as acetaminophen, digoxin, opioid painkillers, tricyclic antidepressants such as amitriptyline, and warfarin, which is a blood thinner.

Salicylate toxicity is a medical emergency. Intentional ingestion or accidental overdose can cause severe metabolic derangements, making treatment difficult. Co-ingestion of other medications can further complicate management. Salicylates are widely available over the counter medications.