Aspirin overdose Texts

TEXT A
Special warnings and precautions for use
If you are receiving medical treatment, are allergic to aspirin or have had a stomach ulcer, seek
your doctor’s advice before taking this product.
The product labelling will include, ‘Do not give to children aged under 16 years unless on the
advice of the doctor”
There is a possible association between aspirin and Reye’s syndrome when given to children.
Reye’s syndrome is a very rare disease which affects the brain and the liver and can be fatal. For
this reason aspirin should not be given to children aged under 16 years unless specifically
indicated (e.g. for Kawasaki’s disease)
Interaction with other medicinal products and other forms of interaction
Aspirin may enhance the effects of anticoagulants and inhabit the effects of uricosurics
Experimental data suggests that ibuprofen may inhabit the effect of low dose aspirin on platelet
aggregation when they are dosed concomitantly. However, the limitations of these data and the
uncertainties regarding extrapolation of ex-vivo data to the clinical situation imply that no firm
conclusions can be made for regular ibuprofen use, and no clinically relevant effect is considered
to be likely for occasional ibuprofen use.
Overdose
Salicylate poisoning is usually associated with plasma concentrations > 350 mg/L (2.5mmol/L).
Most adult deaths occur in patients whose concentrations exceeded 700mg/L (5.1 mmol/L).
Single doses less than 100mg/kg are unlikely to cause serious poising

TEXT B
Symptoms
Common features include vomiting, dehydration, tinnitus, vertigo, deafness, and sweating, warm
extremities with bounding pulses, increased respiratory rate and hyperventilation. Some degree
of acid-base disturbance is present in most cases.
A mixed respiratory alkalosis and metabolic acidosis with normal or high arterial pH (normal or
reduced hydrogen ion concentration) is usual in adults and children over the age of four years. In
children aged four years or less, a dominant metabolic acidosis with low arterial pH (raised
hydrogen ion concentration) is common. Acidosis may increase salicylate transfer across the
blood brain barrier.
Uncommon features include hematemesis, hypoglycemia, hypokalemia, thrombocytopenia,
increased /INR/PTR, intravascular coagulation, renal failure and non-cardiac pulmonary
Oedema.
Central nervous system features including confusion, disorientation, coma and convulsions are
less common in adults than in children.

Management
Give activated charcoal if an adult presents within one hour of indigestion of more than
250mg/kg. The plasma salicylate concentration should be measured, although the severity of
poisoning cannot be determined from this alone and the clinical and biochemical features must
be taken into account. Elimination is increased by urinary alkalinisation, which is achieved by
the administration of 1.26% sodium bicarbonate (first check serum potassium). Forced diuresis
should not be used since it does not enhance salicylate excretion and may cause pulmonary
Oedema.
Hemodialysis is the treatment of choice for severe poisoning and should be considered in
patients with plasma salicylate concentrations > 700mg/L (5.1 mmol/L), or lower concentrations
associated with severe clinical or metabolic features. Patients under ten years or over 70years
have increased risk of salicylate toxicity and may require dialysis at an earlier stage.

TEXT C:
Treatment
Antiemetic
5- HT3 receptor antagonists are most effective as antiemetic. Examples
 Kytril (granisetron HCI)10 up/kg IV over 5 minutes in adults and (PEDS) children under
2 years and older
 Zofran (ondansetron), 8mg IV over 15 minutes (PEDS > 2years 0.15mg/kg)
 Anzemet (dolasetron), 100mg IV over 30 seconds (PEDS> 2years 1.8mg/kg)
Correct Acidosis
Sodium bicarbonate is frequently required to treat academia and to promote salicylate
elimination by the kidneys. To correct metabolic acidosis caused by salicylate intoxication,
administer 0.5 to 1.0 mEq/kg/IV bolus over 2 minutes and repeat as needed to maintain a blood
pH of 7.4 to 7.5

TEXT D
Medications

Activated charcoal: to prevent more absorption, the doctor may give activated charcoal to
absorb the salicylate from the stomach. A laxative system may be given with the activated
charcoal to move the mixture through the gastrointestinal system more rapidly. People who have
been given severely poisoned may be given repeated doses of activated charcoal.
IV fluids: dehydration occurs easily in aspirin poising to correct hydration the doctor will start
an IV to provide fluids. The doctor will also work to correct imbalances in the body’s blood
chemistries.
Alkaline diuresis: This is a way to reduce amount of salicylate in the body. Alkaline diuresis is
the process of giving a person who has been poisoned compounds that alter the chemistry of the
blood and urine in a way that allows the kidneys to remove more salicylate. Specifically, sodium
bicarbonate is given via IV to make the blood and urine less acidic (more alkaline). This
encourages the kidneys to capture more salicylate that can leave the body through the urine.
Sometimes, other components such as potassium also have to be given to help with the process.

Aspirin Overdose: Questions

Questions 1-7
For each question, 1-7, decide which text (A, B, C or D) the information comes from. You may
use any letter more than once.
In which text do you find information about?

1. The various symptoms of a patient who have taken too much aspirin …………………

2. Steps need to be taken while treatment ………………….

3. What medicines are necessary treatment ………………….

4. How to decide the overdose of a drug …………………

 5. What precautions do we need to keep children safe …………………

6. Types of treatments for aspirin overdose ………………....

7. What to consider in treatment management …………………

8. The number of other products that are associated with aspirin ………………..

Questions 9-15
Complete each of the sentences, 9-15, with a word or short phrase from one of the texts. Each
answer may include words numbers or both.
9. Sodium bicarbonate is given via………………. to make the blood and urine more
alkaline.

10. We need to take into consideration of ………………. and ………………… factor while
defining the severity of overdose poising

11. If you are suffering from asthma you need to contact ……………. before taking aspirin

12. …………………………..antagonistic are used for treating over poising

13. Patients under 10 years or more than 70 have expended danger of ………………… and
may require dialysis at a prior stage.

14. Dehydration occurs in the ……………………stage of poising.

15. …………………………may inhibit the effect of low dose aspirin.

Questions 16-20
Answer each of the following questions, 16-20, with a word or short phrase from one of the
texts. Each answer may include words numbers or both.
16. The drug that will enhance the effects of anticoagulants and inhabit the effects of
uricosurics is ……………………………..

17. What method will reduce salicylate level in the body? ..................................
18. Which chemical compound is required to treat academia? ……………………..

19. What will be provided primarily, if a patient presents with over ingestion of aspirin?

20. What do you need to take control of dehydration?

………………………………..