Acute & emergency · UKMLA & AKT
Salicylate overdose
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Salicylate directly stimulates the medullary respiratory centre → hyperventilation → primary respiratory alkalosis (early)
- Uncouples oxidative phosphorylation → anaerobic metabolism → lactic acid + ketoacids → high anion gap metabolic acidosis (late)
- Final picture: mixed respiratory alkalosis + metabolic acidosis
Acidosis shifts salicylate to its unionised form, massively increasing CNS penetration - metabolic acidosis is the danger signal. Never allow the patient to become acidotic; even assisted ventilation risking CO2 retention can precipitate acute neurological collapse.
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