Aspirin overdose Flashcards Preview

Y3 - Conditions and prodedures > Aspirin overdose > Flashcards

Flashcards in Aspirin overdose Deck (7)
Loading flashcards...
1
Q

Define

A
  • Excessive ingestion of aspirin causing toxicity

* Acute ingestion of greater than150mg/kg or 6.5g can cause moderate-severe toxicity in adults

2
Q

What are the risk factors?

A
  • It can be a result of deliberate self-harm, suicidal intent or by accident
  • Children aged 3 years or younger and adults older than 70 more at risk
3
Q

What’s the pathophysiology?

A

o Increases respiratory rate and depth by stimulating the respiratory centre in the brainstem
o This hyperventilation –> respiratory alkalosis (in the early stage)
o The body compensates by increasing urinary bicarbonate and K+ excretion
o This leads to dehydration and hypokalaemia
o Loss of bicarbonate, uncoupling of mitochondrial oxidative phosphorylation and the build up of lactic acid can lead to metabolic acidosis
o In SEVERE cases, CNS depression and respiratory failure can occur

4
Q

Epidemiology

A

• One of the MOST COMMON drug overdoses

5
Q

What are the presenting symptoms?

A
•	Early Symptoms
o	Flushed 
o	Fever
o	Sweating 
o	Hyperventilation 
o	Dizziness 
o	Tinnitus 
o	Deafness
o	GI symptoms – nausea, vomiting, haematemesis, epigastric pain 
•	Later Symptoms
o	Lethargy
o	Confusion
o	Convulsions
o	Drowsiness 
o	Respiratory depression 
o	Coma
6
Q

What are the signs?

A
  • Fever
  • Tachycardia
  • Hyperventilation
  • Epigastric tenderness
7
Q

What are the appropriate investigations?

A

• Bloods
o Salicylate levels (positive or negative)
o FBC – WBC may be elevated
o Blood glucose – hyer or hypoglycaemia
o U&Es - check for hypokalaemia, hypocalcaemia
o Serum ketones – positive particularly in children
o LFTs - high AST/ALT
o Clotting screen - high PT
o Other drug levels (e.g. paracetamol)
o ABG - may show mixed metabolic acidosis and respiratory alkalosis
o Chest x-ray – pulmonary oedema may be present
• ECG
o Signs of hypokalaemia - flattened/inverted T waves, U waves, prolonged PR interval, ST depression
o Sinus tachycardia