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تسجيل

oxicological screening , Salicylates

المؤلف:  Sue Jickells , Adam Negrusz (Editors)

المصدر:  Clarkes Analytical Forensic Toxicology

الجزء والصفحة:  233

2026-10-18

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oxicological screening

Salicylates

Salicylic acid is most often derived from acetyl salicylic acid (aspirin) and severe overdose results in respiratory alkalosis and metabolic acidosis. Children below the age of 4 years are particularly susceptible to salicylate poisoning. Continued absorption of aspirin is common after the initial admission to hospital. Sustained-release salicylate preparations may form concretions in the stomach that result in prolonged absorption as they gradually disintegrate. Application of salicylate-containing ointments to abnormal skin can also lead to significant toxicity, as can the use of teething gels in infants. Chronic salicylate poisoning can occur in rheumatic patients who take large doses of aspirin, and salicylism should be considered in any elderly patient with unexpected delirium or dementia. Ingestion of methyl salicylate is rare, but it is potentially more dangerous because of rapid absorption. Treatment of severe salicylate poisoning involves sodium bicarbonate infusions, multiple doses of oral activated charcoal and, in severe cases, haemodialysis. Toxicity is associated with plasma salicylate concentrations of 300 mg/L or greater. Adults with plasma salicylate concentrations less than 450 mg/L and children with plasma salicylate concentrations less than 350 mg/L do not require specific treatment. The slow and continuous absorption of the drug may necessitate repeat plasma salicylate determinations.