Adverse Effects

Pulmonary Adverse Effects

Gastrointestinal Adverse Effects

Renal Adverse Effects

Pseudo-Sepsis Syndrome

Salicylate Intoxication



Effects of Salicylate Intoxication


Clinical Manifestations

Cardiovascular Manifestations

Endocrinologic Manifestations

Neurologic Manifestations

Pulmonary Manifestations

Renal Manifestations

Other Manifestations

  • Fever (due to uncoupling of oxidative phosphorylation, with increased heat production):
  • Coagulopathy (38% of cases): GI bleeding, etc. due to decreased platelet aggregation and some hepatocyte damage with prolonged PT


  • Alkaline diuresis: IVF with HCO3
  • GI Decontamination (may be useful even 12-24 hrs after ingestion): indicated for ingestion of >150 mg/kg
  • Charcoal: may repeat
  • Antacids: to decrease local GI toxicity
  • Alkalinization of Blood/Urine: using bicarbonate (titrated to achieve normal blood pH)
    • Moves salicylic acid out of tissues (and CNS) and enhances renal excretion
    • Acetazolamide enhances urinary bicarbonate excretion but should not be used in these cases
  • Hydration with Forced Diuresis (with mannitol, etc.): renal excretion is also enhanced in presence of increased GFR with high urine flow
  • Use cautiously in setting in pulmonary edema
  • Glucose Administration: crucial since brain glucose may be depleted even in presence of normal serum glucose levels
  • Hemodialysis/Charcoal Hemoperfusion (for severe or refractory cases): removes salicylic acid and corrects metabolic acidosis


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