Question

Salicylate poisoning: 
Pathophysiology. 
 

Hint:

In cases of salicylate poisoning, both respiratory alkalosis and metabolic acidosis should be corrected simultaneously to avoid further complications.

Answer 1

Step 1: Understanding Salicylate Poisoning.
Salicylate poisoning occurs when there is an overdose of salicylates (e.g., aspirin), leading to toxic effects on various organs and systems. It is a common cause of poisoning, especially in children, and requires urgent management.

Step 2: Pathophysiological Mechanism.
1. Acid-base disturbances: Salicylates cause metabolic acidosis by increasing the production of organic acids and by inhibiting cellular respiration. This results in decreased bicarbonate levels and the accumulation of lactic acid.
2. Respiratory alkalosis: Salicylates stimulate the respiratory center in the brain, causing hyperventilation. This leads to a decrease in CO2 levels, resulting in respiratory alkalosis.
3. Increased cellular metabolism: Salicylates increase the metabolic rate, leading to elevated body temperature and increased oxygen consumption, which can contribute to tissue hypoxia and organ dysfunction.
4. Enzyme inhibition: Salicylates inhibit cyclooxygenase (COX), leading to decreased production of prostaglandins. This affects many body systems, including the gastrointestinal and renal systems.

Step 3: Conclusion.
Salicylate poisoning involves a combination of respiratory alkalosis, metabolic acidosis, increased metabolic rate, and enzyme inhibition, which lead to systemic effects such as organ dysfunction and increased risk of complications.