UMEM Educational Pearls

Category: Toxicology

Title: Salicylate Toxicity- Mechanism

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

Posted: 11/3/2011 by Ellen Lemkin, MD, PharmD (Updated: 1/27/2023)
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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. 

References

 

MicromedexPoisindexsalicylate poisoning.