Module 9: Salicylate Toxicity Conclusion and Summary

9.1. Course Summary and Key Takeaways

As we come to the close of our comprehensive overview of Salicylate Toxicity, we hope you have gained an in-depth understanding of this critical subject. We’ve journeyed from the historical origins of salicylates to their modern usage, delved into the pathophysiology of salicylate toxicity, and discussed the key steps in diagnosing and managing it.

Key learning points to take away include:

– The crucial role of pharmacists and healthcare professionals in recognizing and managing salicylate toxicity.

– The importance of early detection and timely intervention in salicylate toxicity, especially regarding urine alkalinization and, in severe cases, hemodialysis.

– The relevance of supportive care, including hydration, electrolyte balance, symptom control, and respiratory support.

– The necessity for thorough follow-up care and patient education to prevent recurrence of toxicity.

Remember, every patient is unique, and clinical judgement is paramount in applying this knowledge.

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9.2 References

1. Dart RC, Rumack BH, Mckinney PE. Acetominophen poisoning. In: Goldfrank’s Toxicologic Emergencies. 11th ed. New York, NY: McGraw-Hill Education; 2019:chap 37.

2. Lugassy D. Salicylates. In: Goldfrank’s Toxicologic Emergencies. 11th ed. New York, NY: McGraw-Hill Education; 2019:chap 58.

3. Goldfrank LR, Lewin NA, Howland MA, Hoffman RS, Nelson LS. Goldfrank’s Toxicologic Emergencies. 11th ed. New York, NY: McGraw-Hill Education; 2019.

4. Mowry JB, Spyker DA, Cantilena LR Jr, McMillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 31st Annual Report. Clin Toxicol (Phila). 2014;52(10):1032-1283.

5. Gosselin S, Juurlink DN, Kielstein JT, et al. Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Ann Emerg Med. 2015;66(2):165-181. 

6. Chyka PA, Erdman AR, Christianson G, et al; American Association of Poison Control Centers; Healthcare Systems Bureau, Health Resources and Services Administration, Department of Health and Human Services. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(2):95-131.

7. Algra AM, Rothwell PM. Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. Lancet Oncol. 2012;13(5):518-527.

8. Juurlink DN, Gosselin S, Kielstein JT, et al. Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Ann Emerg Med. 2015;66(2):165-181.

9. American College of Medical Toxicology. Guidance document: management priorities in salicylate toxicity. J Med Toxicol. 2015;11(1):149-152.

10. Patrono C, Baigent C, Hirsh J, Roth G; American College of Chest Physicians. Antiplatelet drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):199S-233S.

11. Roberts LJ, Morrow JD. Analgesic-antipyretic and antiinflammatory agents and drugs employed in the treatment of gout. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006:687-731.

12. Temple AR. Acute and chronic effects of aspirin toxicity and their treatment. Arch Intern Med. 1981;141(3 Spec No):364-369.

13. Glasser SP, Selwyn AP, Braunwald E. Drug therapy: Management of patients with stable angina pectoris. N Engl J Med. 1978;299(17):922-931.

14. Feldman S, Smith HJ. Bismuth chelation molar ratios and efficacy of bismuth subsalicylate and salicylate in mice infected with Helicobacter pylori. J Pharm Sci. 1999;88(5):551-555.