Her condition stabilized with no new symptoms. She was observed closely for the development of new symptoms, and her biochemical parameters were monitored closely. She received two sessions of hemodialysis, each lasting 4 h on two consecutive days. In view of the lethal-dose consumption of Aspirin and delay in the reporting of salicylate levels, she was started on hemodialysis by a high-flux dialyzer with a surface area of 1.9 m 2. She received intravenous sodium bicarbonate 1 meq/kg as bolus dose. Her baseline investigations, including coagulation parameters, were unremarkable. The patient was started on activated charcoal. Table 1 lists the parameters throughout the stay in the hospital. The patient was a known case of well-controlled hypertension on calcium channel blockers. There was no past history of any psychiatric illness.
She was fully conscious, oriented in time space and person, moving all four limbs. Her physical examination was unremarkable. She was fully conscious and complained of tinnitus on admission however, she did not complain of nausea, vomiting, vertigo, and breathlessness. Case HistoryĪ 25-year-old female was brought to the emergency 2.5 h after consumption of 70 tablets of Aspirin 0.5 g. We report an interesting case of salicylate consumption in a lethal dose that was treated successfully with prompt hemodialysis. Activated charcoal is commonly used in this situation. Due to the non-availability of an antidote, treatment can be a challenge, and the best treatment choice is enhanced elimination and prevention of further absorption. Many deaths have been reported in the past due to aspirin overdose overall mortality is 0.01%, but it increases to 15% in severe toxicity.
Due to its widespread use and easy availability over the counter, its toxicity is still an important problem in clinical practice.
It has a low volume of distribution (0.2 L/kg), although higher values have been reported after overdose. After ingestion, acetylsalicylic acid is rapidly hydrolyzed to salicylic acid. It is extensively (90%) bound to albumin but can decrease by 30% in overdose. Aspirin or salicylates are among the commonly used and trusted drugs in medical practice.
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