Salicylate Toxicity- A comprehensive review by NEJM
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Salicylate poisoning is characterized as either acute or chronic. The acute form of salicylate intoxication generally occurs in young adults who have a psychiatric history or who have had a previous overdose. Chronic poisoning is more common in elderly patients, who often are cared for by more than one clinician and therefore are at risk for inadvertent dual prescribing. Use of nonprescription drugs as therapy for symptoms of associated medical problems or in a misguided attempt to relieve symptoms can lead to accidental intoxication.

There is no specific antidote for salicylate poisoning. The initial approach is to perform a rapid clinical assessment and initiate supportive therapy, with particular attention to ensuring adequate respiration and stabilizing the circulation. Alkalinization of the urine to accelerate kidney clearance of salicylate is essential in the management of both acute and chronic intoxication.

Salicylates are found in numerous substances that can be ingested together, inadvertently leading to life-threatening toxic effects. Clinicians are reminded that many of the signs and symptoms of salicylate poisoning mirror those of viral infections, including Covid-19, as well as other conditions.

Source: https://www.nejm.org/doi/full/10.1056/NEJMra2010852?query=featured_home
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