What is the first symptom of salicylate toxicity?

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.

Does urine alkalinization increase salicylate elimination if so why?

Experimental and clinical studies confirm that urinary alkalinization increases salicylate elimination, although the mechanisms by which this occurs have not been elucidated. The conventional view is that ionisation of a weak acid, such as salicylic acid, is increased in an alkaline environment.

What happens in an aspirin overdose pH?

Aspirin has a direct effect on the respiratory center in the brain leading to hyperventilation. The body responds to hyperventilation by having the kidneys produce more bicarbonate and excrete more potassium which leads to an elevated anion gap metabolic acidosis.

What is the antidote of aspirin?

Sodium bicarbonate is given in a significant aspirin overdose (salicylate level greater than 35 mg/dl 6 hours after ingestion) regardless of the serum pH, as it enhances elimination of aspirin in the urine. It is given until a urine pH between 7.5 and 8.0 is achieved.

Does aspirin contain salicylates?

Salicylates are found in plants. They’re a natural ingredient in many fruits, vegetables, and spices. Synthetic salicylates are a major ingredient in aspirin and other pain-relieving medications. Natural and synthetic salicylates also are in many common health and beauty products.

What causes alkalinization of urine?

Increasing the pH of urine increases the degree of ionization of weak acids and reduces passive reabsorption. Urine alkalinization is a treatment regimen that increases poison elimination by the administration of intravenous sodium bicarbonate to produce urine with a pH ≥7.5.

What is the major source of salicylate excreted in urine?

Our results (table 1​) show that more SU is excreted in the urine of vegetarians than in the urine of non-vegetarians, and this finding is entirely consistent with the observation that fruits and vegetables are the major dietary sources of salicylates.

Why does aspirin cause acidosis?

Aspirin directly stimulates cerebral respiratory centers and inhibits the citric acid cycle, causing uncoupling of oxidative phosphorylation which ultimately leads to lactic acidosis. Patients who present with aspirin toxicity may initially appear well before acute decompensation.