Fatal dose:
~10-30g by adult
~3g by child
~10-30g by adult
~3g by child
Aspirin
Oil of Wintergreen
Oil of Wintergreen is very concentrated - 5mL contains equivalent of 7.5g of aspirin.
Pepto-Bismol
Wart removers
Maalox
Alka-Seltzer
Oil of Wintergreen is very concentrated - 5mL contains equivalent of 7.5g of aspirin.
Uncouples oxidative phosphorylation → increased metabolic rate and hyperthermia
As level rises, switches from hepatic to renal clearance (slower)
Nausea/vomiting
Stimulates chemoreceptor trigger zone
May cause metabolic alkalosis (contraction alkalosis)
Respiratory alkalosis
Activates respiratory center of medulla
If have respiratory acidosis, consider: pulmonary edema, co-ingestion of respiratory depressant or fatigue
Leads to compensatory alkaluria: urinary excretion of potassium and sodium bicarb
Anion gap metabolic acidosis
Interferes with cellular metabolism
Normal AG does not exclude ASA toxicity in patient with an unknown ingestion (mixed picture)
Hyperthermia
Uncouples oxidative phosphorylation
As pH drops more ASA is uncharged; able to cross BBB
Altered mental status
Direct toxicity of<unk>  species in the CNS
Cerebral edema
Neuroglycopenia<unk>  increases CNS utilization of glucose, serum glucose levels may not reflect CNS levels.
Pulmonary edema
Usually occurs in elderly
Due to increased pulmonary vascular permeability
Fetal Effects in pregnancy
Increased fetal morbidity and mortality
Un-ionized<unk>  cross the placenta due to higher fetal pH, where it becomes ionized and accumulates in the fetus
Due to fetal inability to hyperventilate leads to worsening acidosis
There can be displacement of bilirubin from protein binding sites allowing it  to cross the blood brain barrier, which can lead to kernicterus.
Due to inhibition of prostaglandin synthesis, can lead to premature closure of the ductus arteriosus
Stimulates chemoreceptor trigger zone
May cause metabolic alkalosis (contraction alkalosis)
Activates respiratory center of medulla
If have respiratory acidosis, consider: pulmonary edema, co-ingestion of respiratory depressant or fatigue
Leads to compensatory alkaluria: urinary excretion of potassium and sodium bicarb
Interferes with cellular metabolism
Normal AG does not exclude ASA toxicity in patient with an unknown ingestion (mixed picture)
Uncouples oxidative phosphorylation
As pH drops more ASA is uncharged; able to cross BBB
Direct toxicity of<unk>  species in the CNS
Cerebral edema
Neuroglycopenia<unk>  increases CNS utilization of glucose, serum glucose levels may not reflect CNS levels.<unk>  increases CNS utilization of glucose, serum glucose levels may not reflect CNS levels.
Usually occurs in elderly
Due to increased pulmonary vascular permeability
Increased fetal morbidity and mortality
Un-ionized<unk>  cross the placenta due to higher fetal pH, where it becomes ionized and accumulates in the fetus
Due to fetal inability to hyperventilate leads to worsening acidosis
There can be displacement of bilirubin from protein binding sites allowing it  to cross the blood brain barrier, which can lead to kernicterus.
Due to inhibition of prostaglandin synthesis, can lead to premature closure of the ductus arteriosus
Salicylate toxicity
Lactic acidosis
Chlorate toxicity
Sepsis, shock, liver disease, CO, CN, metformin, methemoglobin
Organophosphate toxicity
Short bowel syndrome
Thallium toxicity
Propylene glycol infusions for lorazepam and phenobarbital