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Salicylate (Aspirin) Poisoning

Salicylate poisoning is a serious emergency with mixed acid-base disturbance and central nervous system dysfunction.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Salicylate (Aspirin) Poisoning?

Salicylates (acetylsalicylic acid and derivatives) uncouple mitochondrial oxidative phosphorylation, impair cellular energy production, stimulate the central nervous system, and increase anaerobic metabolism. In acute poisoning, doses above 150 mg/kg are toxic.

Clinically, respiratory center stimulation produces hyperventilation and respiratory alkalosis, followed by lactic acidosis and ketone formation that yield a high anion gap metabolic acidosis. The mixed acid-base picture is the hallmark of salicylate poisoning.

Treatment increases renal excretion through ion trapping with alkaline urine; severe cases may require hemodialysis. Chronic poisoning is often diagnosed late and carries higher mortality.

Symptoms

Tinnitus and reduced hearing
Deep, fast respiration (Kussmaul-type hyperpnea)
Nausea, vomiting, and epigastric burning
Fever, sweating, and dehydration
Confusion, agitation, and lethargy
Seizures, coma, and pulmonary edema in severe cases

Risk Factors

Acute high-dose ingestion (suicidal intent)
Chronic supratherapeutic use in older adults
Hepatic or renal failure
Topical methyl salicylate (oil of wintergreen) ingestion
Reye syndrome risk in pediatrics
Concomitant dehydration and hypokalemia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call 112 immediately for suspected aspirin overdose
  • Tinnitus and hyperventilation must be evaluated
  • Obtain blood gas, electrolytes, and salicylate level
  • Patients with high levels or clinical deterioration require ICU admission

Treatment Methods

01
Airway protection with cautious hyperventilation during intubation
02
Activated charcoal early and based on gut motility
03
Sodium bicarbonate for alkaline diuresis (target urine pH 7.5-8)
04
Potassium replacement and correction of dehydration
05
Hemodialysis at high levels, neurological deterioration, or renal failure
06
Continuous monitoring in intensive care

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.