Symptoms of overdose caused by acetylsalicylic acid may occur after a single dose of a large dose or with prolonged use. If a single dose is less than 150 mg / kg, acute poisoning is considered mild, 150 - 3.02 mg / kg - moderate and when applied at doses greater than 300 mg / kg - heavy.
Symptoms: With mild poisoning - salicylism syndrome (nausea, vomiting, tinnitus, visual impairment, dizziness, severe headache, general malaise, fever - a poor prognostic sign in adults).
With a significant overdose - confusion, drowsiness, convulsions and coma, tremor, noncardiogenic pulmonary edema, dyspnea, choking, water-electrolyte balance disorders, renal failure, collapse and shock.
The greatest risk of developing chronic intoxication is observed in the elderly with more than 100 mg / kg / day for several days. In children and elderly patients, the initial signs of salicylism are not always noticeable, so it is advisable to periodically determine the salicylate content in the blood: a concentration above 70 mg% indicates moderate or severe poisoning; above 100 mg% - about extremely severe, prognostically unfavorable. With moderate and severe poisoning, hospitalization is necessary.
Treatment: Provocation of vomiting, the appointment of activated charcoal and laxatives, alkalinization of urine (shown at a salicylate concentration above 40 mg%, is provided by intravenous infusion of sodium bicarbonate - 88 meq per 1 liter of 5% dextrose solution, at a rate of 10-15 ml / kg / h) , restoration of the volume of circulating blood and induction of diuresis (achieved by adding sodium bicarbonate solution in the same dose and dilution, repeat 2-3 times); it should be borne in mind that intensive fluid infusion of the elderly can lead to pulmonary edema.We do not recommend the use of acetazolamide for alkalinization urine (acidosis can cause toxic effects and enhance salicylates). Hemodialysis is indicated in salicylate concentration of 100-130 mg%, and in patients with chronic poisoning - 40 mg% or less when indicated (refractory acidosis, progressive deterioration severe damage to the central nervous system, lung edema and renal failure). It is shown in pulmonary edema artificial ventilation with a mixture enriched in oxygen at a positive pressure mode at the end of the exhalation; To treat edema of the brain, hyperventilation and osmotic diuresis are used.
Caffeine in doses more 300 mg / day (including the background abuse coffee - a cup natural coffee 4, 150 ml) can cause, anxiety, tremor, headache, pain, confusion, extrasystole. Treatment: Vomiting provocation, reception of activated coal.