These medications possess anti-inflammatory, analgesic, and antipyretic properties. Early administration of activated charcoal decreased absorption and use of bicarbonate enhanced elimination.Īctivated charcoal Aspirin Bicarbonate Overdose Poisoning Salicylate.Salicylates are agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs.
Bicarbonate was administered in 34 (26%) presentations, decreasing the median apparent elimination half-life from 13.4 to 9.3 h (difference: 4.2 h, 95% CI: 1.0-6.5 h).Īcute aspirin overdose caused only mild to moderate effects in this series.
Activated charcoal was administered in 36 (27%) cases, which decreased the median peak salicylate concentration (34.2 to 24.8 mg/L/g (difference: 9.4, 95% CI: 1.0-13.1)). There was a moderate association between dose ingested and peak concentration (Pearson r = 0.58 95% CI 0.45-0.68). The median peak salicylate concentration was 276 mg/L (IQR: 175-400 mg/L, range: 14-814 mg/L). There were no cases of severe toxicity (coma or seizures) due to aspirin alone. Moderate toxicity (acid-base disturbance, confusion) occurred in 16 with a median ingested dose of 297 mg/kg. Mild toxicity (nausea, vomiting, tinnitus or hyperventilation) occurred in 22 with a median dose of 160 mg/kg. The median age was 28 years (range: 13-93 years). There were 132 presentations in 108 patients (79 females (73%)). Included in our analysis was demographic data, clinical effects, investigations, complications, and treatment. Excluded were cases of chronic exposure, hospital presentation > 24 hours after ingestion, and cases without a salicylate concentration.
Acute aspirin ingestions > 3000 mg were identified in each unit's database. This is a retrospective series of acute aspirin overdose from two toxicology units from January 2000 to September 2019. We investigate our experience of aspirin overdose and the effectiveness of charcoal and bicarbonate administration over 20 years. Management is guided by research reported over 50 years ago when chronic aspirin toxicity was common and accounted for significant morbidity. Aspirin overdose causes acid-base disturbances and organ dysfunction.