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Aspirin toxicity

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Aspirin toxicity

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Aspirin toxicity

  1. 1. Group 8 (36-40); Faisal Farooq Fareeha Gul Fatima Alam Syed Hassaan Masroor Eman Afroze Instructor : Dr. Hira
  2. 2. By; Fatima Alam Syed Hassan Masroor Group: 8 (36-40)
  3. 3. BLOOD TESTS ABG-TEST (Arterial Blood Gas Test) Serum Salicylate Level Test
  4. 4. Faisal Farooq Fareeha Gul Presenters of Group 8 (36-40)
  5. 5. Chemically “ Acetylsalicylic acid” [ASA].   A part of a drug family known as NSAIDs or non-steroidal anti-inflammatory drugs.
  6. 6. Uses Of ASPIRIN analgesic (Pain Killer) Anti-pyretic (Anti-fever) Anti-inflammatory drug For Cardio-Vascular Diseases (prevents blood clot formation)
  7. 7. Mode Of Action Of ASPIRIN
  8. 8. AD Acid serine COX Prostaglandins free nerve endings CNS Damaged cells release arachidonic acid PAIN Normal Pain Sensation Mechanism
  9. 9. Aspirin Aspirin Damaged cells release arachidonic acid AD Acid serine COX Acetyl- Prostaglandins PAIN In the presence of ASPIRIN
  10. 10. What’s the need to inhibit synthesis of “prostaglandins”….? Actions of PROSTAGLANDINS Actions Of ASPIRIN 1. Sensitize spinal nerves to pain. 2. Regulate inflammatory mediation. 3. Act on thermoregulation centers in hypothalamus to produce fever. 4. Act on glomerular cells to increase filtration rate. 5. Act on parietal cells in stomach to inhibit acid secretion. Removes PAIN Removes INFLAMMATION Prevents FEVER Decrease filtration rate, can cause Renal Insufficiency More ACID secretion, can cause GI- Toxicity Thromboxane causes platelet aggregation. Aspirin prevents blood clot formation by inhibiting thromboxane synthesis. Therefore ASPIRIN is used by cardiac patients to prevent heart attack. These patients have a slogan “An Aspirin A Day, Keeps The Doctor Away”.
  11. 11. Aspirin toxicity or SALICYLISM is acute or chronic poisoning with overdose of aspirin. o10-30 mg/d L: Therapeutic level (No Poisoning)o>30 mg/d L : 1st Sign of toxicity o if >100mg/d L: Early hemodialysis should be considered •Uncoated tabs (therapeutic doses): 15-20 mins. • Enteric coated tabs: 18-24 hours Salicylate Levels Absorption Aspirin Toxicity
  12. 12. CAUSES 0f ToxicityAccidental Intentional Accidental ingestion by pre-school children or elderly 1. Suicidal Attempt by adults or teenagers. 2. Therapeutically acquired intoxication.
  13. 13. August 12, 1977 Theodore Hirschberg vs. State Of NY New York Court Of Claims •No doctors available psychiatrist •Examination revealed toxicity symptomology but doctor couldn't diagnose. •No diagnostic tests done. •Transfer advice. •No physical examination. •No test. •Physician thought his colleague had seen the patient. •Gave patient anti-psychotic and put him on suicide alert. •Later investigations revealed that the doctor was not licensed. $ 35,000/-•Suicide Attempt….why? •Because the person faces hallucinations/convulsions. Symotomology does reveal; FEVER, TINNITUS, NAUSEA, TACHYPNEA etc.
  14. 14. Tinnitus Tachypnea Nausea/Vomiting Abdominal Pain •Electrolyte Abnormalities •Metabolic Acidosis • Respiratory Alkalosis •AMS (Altered mental status) •Cerebral edema Pulmonary edema Renal Failure •Hyperthermia •Convulsions/ Hallucinations • Seizures • Coma SYMPTOM S Common Sever e Ataxia
  15. 15. Salicylates inhibit Krebs Cycle and uncouple oxidative phosphorylation Glucose cannot be metabolized, Decreased ATP concentration Cellular metabolic activity increases to synthesize more ATPs Increased uptake of GLUCOSE from plasma by cells Hypoglycemia Formation of KETONE BODIES as alternate energy source AMS (Altered Mental Status) Metabolic Acidosis Results in respiratory alkalosis as compensation for metabolic acidosis Biochemistr y
  16. 16. Patholog y
  17. 17. SYMPTOMS Mild Toxicity < 150 mg/kg Moderate Toxicity 150-300 mg/kg Severe Toxicity >300 mg/kg Nausea/ Vomiting Confusion AMS ( Altered mental status ) Tinnitus Tachypnea Respiratory arrest Hearing Loss Hyperpyrexia Renal failure Dizziness Diaphoresis Arrhythmia Ataxia Shock Anxiety Seizures Coma Amount Ingested Toxicity Level
  18. 18. Diagnosis Physical Examinatio n ABG Test [Arterial Blood Gas Test] Serum Salicylat e Levels Fever Tinnitus Tachypnea N/V Abdominal Pain >30 mg/d L, toxicity is present Respiratory Alkalosis

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