The later is important as it may affect the rate of absorption. These include time of ingestion, amount ingested, as well as formulation. If the patient can provide history, there are several important pieces of information to obtain. Theoretically, this may occur in children or patients with compromised skin, such as due to burns or psoriasis.

However, the serum concentrations do not reach toxic levels. Elimination is further delayed in patients with underlying renal and liver disease.ĭermal salicylate preparations have been shown to reach the bloodstream. With increased salicylate levels, these pathways become saturated resulting in zero order elimination. The liver metabolizes salicylates by first-order elimination, and the inactive metabolites are then excreted in the urine.

Absorption continues in the small intestine. Aspirin can cause pyloric sphincter spasms, which increases the amount of time in the stomach allowing for more absorption. Aspirin has the propensity to form bezoars which will delay absorption. Food in the stomach at the time of ingestion can delay absorption. The formulation of the salicylate (extended vs. A variety of factors can affect absorption.

Diuresis, hemodialysis, and hemoperfusion are effective, but the latter two rarely are necessary.The ionization constant of aspirin is 3, which makes it is more readily absorbed in acidic environments such as the stomach. Fluid and electrolyte management is the mainstay of therapy. Blood level determinations are good prognostic indicators for acute ingestions but are of limited value in chronic, therapeutically induced salicylism. For acute ingestions, the magnitude of the poisoning is clearly dose related. With chronic, therapeutically induced salicylism, these symptoms may be mistaken for symptoms resulting from the illness for which the salicylates were administered. Alkalemia or acidemia, alkaluria or aciduria, hypoglycemia or hyperglycemia, and water and electrolyte imbalances may occur nausea, vomiting, tinnitus, hyperpnea, hyperpyrexia, disorientation, coma, and/or convulsions are common. Salicylate poisoning remains a major clinical hazard, usually resulting from accidental ingestions in preschool children, suicidal overdoses in adults and teenagers, and therapeutically acquired intoxication in all ages.

Aspirin toxicity antidote