UMEM Educational Pearls

Title: Salicylate Toxicity- Mechanism

Category: Toxicology

Keywords: salicylate, aspirin, alkalosis, acidosis (PubMed Search)

Posted: 11/3/2011 by Ellen Lemkin, MD, PharmD (Updated: 12/26/2024)
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Salicylates:

stimulate the respiratory center in the brainstem, causing respiratory alkalosis
interfere with the Krebs cycle, limiting ATP production, leading to an anaerobic metabolism
uncouple oxidative phosphorylation, causing accumulation of pyruvic and lactic acid and heat production, resulting in acidosis and hyperthermia
increase fatty acid metabolism, generating ketone bodies

Overall, this results in a mixed respiratory alkalosis and metabolic acidosis.

Micromedex; Poisindex, salicylate poisoning.