Clinical Information

Therapeutic salicylates include, among others, salicylic acid, sodium salicylate, methyl salicylate (oil of wintergreen), and acetylsalicylic acid (aspirin).

Aspirin is an analgesic, antipyretic, anti-inflammatory drug contained in a large number of preparations. Aspirin is rapidly hydrolyzed by hepatic and blood esterases to the pharmacologically active intermediate, salicylic acid, which has a dose-dependent serum half-life ranging from 3 to 20 hours.

Stimulation of the respiratory center in the central nervous system and uncoupling of oxidative phosphorylation are direct effects of salicylate that lead to many of the toxic symptoms observed in overdose situations.

Symptoms of salicylate toxicity can include nausea, vomiting, tinnitus, headache, hyperpnea, confusion, hyperthermia, slurred speech, and convulsions. Acid-base disturbances such as compensated respiratory alkalosis (mild toxicity) and metabolic acidosis with increased anion gap (severe toxicity) are commonplace.