Acute & emergency · UKMLA & AKT
Salicylate overdose
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise salicylate overdose — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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