Transcript SALICYLIC ACID

SALICYLIC ACID
Made by Dr. Amna Rao
Presented by Sobia Hussain
Roll # 80
SALICYLIC
ACID
• An odorless, crystalline solid substance.
• Has a sweetish taste.
• Used externally for treatment of skin
diseases.
• It has a remote action after absorption.
• Causes marked irritation of gastric mucous
membrane.
• Important preparations:
• Sodium salicylate and methyl salicylate (oil
of winter green) are important prepations of
salicylic acid.
• Natural forms:
• Salicin and methyl salicylate are naturally
occuring forms, found in leaves and bark of a
number of plants (willow tree).
FATAL DOSE
• Salicylic Acid: 70-80 grams.
• Sodium Salicylate and Acetyl Salicylic
Acid: 15-20 grams.
• Methyl Salicylate: 10-20 ml.
FATAL PERIOD
• Salicylic Acid: 4-7 days
• Sodium Salicylate: 1-3 days
• Methyl Salicylate: 12-24 hours.
CLINICAL FEATURES:
• In Therapeutic Doses, aspirin is absorbed
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rapidly from small intestine and stomach walls.
In Overdose absorption may occur more
slowly and plasma salicylate concentration may
rise up to 24 hours.
Salicylates stimulate respiratory centers in
medulla & increase rate and depth of
respiration. CO2 is eliminated from the lungs
causing respiratory alkalosis.
• Dehydration and hypokalaemia results due
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to excess sodium, potassium and water
excreted in urine.
Metabolic Acidosis develops because of
interference with lipid, protein, carbohydrate
and amino acid metabolism by salicylate ions.
Primary toxic effect of salicylate overdose
is hyperpyrexia, sweating, fluid loss, nausea
and vomiting.
CNS: acidaemia, tremors, delirium, convulsions,
stupor and coma; so called salicylate jag.
Renal Involvement: maybe shown by
proteinuria, sodium and water retention and
tubular necrosis.
Tinnitus: deafness and increased labyrinthine
pressure occurs. Coma occurs in terminal
stages.
MANAGEMENT
• Stomach wash.
• Gastric lavage with sodium bicarbonate
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solution.
Activated charcoal suspension can be used.
Forced alkaline diuresis can be helpful in
eliminating aspirin and other salicylates from the
body.
Sodium Bicarbonate in the dose of 1-2 meq/kg
can be given intravenously.
IV fluids to correct electrolyte imbalance.
Vitamin K can be given in case of severe
hypoprothrombinaemia.
POSTMORTEM
APPEARENCE:
• These include evidence of:
• Hemorrhagic gastritis
• Subpleural and subpericardial hemorrhages
• Pulmonary and cerebral edema
• Renal irritation
• Congestion of viscera
MEDICOLEGAL
ASPECTS:
• Accidental Poisoning common in children. In
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adults cause hypersensitivity reactions.
Suicidal poisoning uncommon.
In neotaes, infants and children salicylate
intoxication may occur through placental transfer,
breast milk or by application of teething gel to the
gums.
United states studies have suggested an
association between Reye syndrome and use of
salicylates. Salicylates should not be used in children
under 12 years indicated for Childhood Rheumatic
Condition.
• Aspirin Hypersensitivity:
• Increase salicylate levels.
• Fatal hypersensitivity reaction occurs
within minutes of ingestion.
• Causes vasomotor rhinitis, angioneurotic
edema and utricaria.
• Laryngeal edema results in death.
• Treatment involves immediate
administration of adrenaline (s/c) and
corticosteroids.
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