1/6/2023 0 Comments Aspirin antidoteMany over-the-counter combination medications contain aspirin.That's as few as 30 tablets of 325-mg aspirin. Aspirin (lethal dose is really low (~150 mg/kg or ~10-30 grams).⚠️ If any doubt exists, call nephrology & poison control for help early & often.(5) Salicylate >80 mg/dL (5.8 mM) with renal dysfunction and despite fluid resuscitation/alkalinization.(4) Salicylate >90 mg/dL (6.5 mM) with renal dysfunction, or despite fluid resuscitation/alkalinization.(1) Altered mental status or pulmonary edema.Aggressively replete potassium to maintain >4-4.5 mEq/L (it will drop).Follow with isotonic bicarbonate (150 mEq/L) as maintenance fluid at ~200 ml/hr. Start with 2-3 amps (50 mEq each) of bicarb given as a slow push over ~10 min.Indicated if salicylate >40 mg/dL (>2.9 mM) and/or symptoms (i.e., most significant intoxications).DO NOT give normal saline (this worsens acidosis).
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