It occurs when taking single-dose high doses of acetylsalicylic acid (more than 100 mg / kg) or prolonged use of acetylsalicylic acid in elevated doses (salicilism).
When taking acetylsalicylic acid in a dose of 150-200 mg / kg (or at a level of salicylates in the plasma 50-80 mg / dL), light-type poisoning develops. Characteristic is the appearance of ringing in the ears, hyperventilation due to stimulation of the respiratory center, respiratory alkalosis due to loss FROMO2.
When taking acetylsalicylic acid in a dose of 200-300 mg / kg (or at a level of salicylates in the plasma 80-110 mg / dL), moderate severity is developed.
There are severe shortness of breath, hyperthermia due to dissociation of oxidation and phosphorylation (poor prognostic sign in adults), metabolic acidosis due to increased anaerobic glycolysis.
When taking acetylsalicylic acid in a dose of 300-500 mg / kg (or at a level of salicylates in plasma 110-160 mg / dL) severe poisoning develops. There is a collapse, coma, convulsions, hypoprothrombinemia.
At reception of acetylsalicylic acid in a dose> 500 mg / kg (or at a level of salicylates in a plasma> 160 mg / dl) extremely serious poisoning with renal and respiratory insufficiency develops.
Measures of assistance include drug cancellation, vomiting provocation or gastric lavage with activated charcoal and the appointment of salt laxatives to prevent absorption of the drug in the stomach and intestines. The introduction of alkalizing agents to maintain the pH of the urine at a level of 7.5-8.0. At the level of salicylates in plasma more than 300 mg / l (2.2 mmol / l) in children and 500 mg / l (3.6 mmol / L) in adults, an intensive alkaline diuresis (provided by intravenous infusion of sodium bicarbonate 88 meq / l and 5% glucose at a rate of 10-15 ml / kg / h with furosemide 40-60 mg).The recovery of the bcc and the correction of the KHS are carried out. At the level of salicylates more than 1000 mg / l, as well as with refractory acidosis, hemodialysis is indicated. When the brain is swollen, the IVL is shown to be a mixture enriched with oxygen in the positive pressure mode at the end of the exhalation. With edema of the brain, hyperventilation is performed in combination with the administration of osmotic diuretics. There is no specific antidote.
Use for urine alkalinization acetazolamide when treating intoxication is not recommended in connection with the possibility of developing acidemia and enhancing the toxic effect of salicylate on the patient's body.