Salicylate Intoxication in the Elderly

摘要: Aspirin (acetylsalicylic acid) and its salicylate derivatives are effective antipyretic, analgesic, anti-inflammatory agents that still very widely used by the elderly despite advent of newer, potentially safer nonsteroidal drugs (NSAIDs). However, none new NSAIDs have been proven to be more than aspirin or salicylic acid. Chronic intoxication which is most common in elderly, may occur with therapeutic doses. Increased toxicity older patients often appears due inadvertent overdosage. Dual prescribing additional use nonprescription salicylates some causes unwitting long term toxicity. According studies, systemic clearance (mainly hepatic metabolism) reduced age, as renal elimination. These changes increased importance using high doses when metabolism saturated unchanged drug available for excretion. In face impairment, risk increased. The diagnosis acute generally does not pose diagnostic problems. Patients present a history intentional overdose, hyperventilation, fever, nausea. can confirmed measuring serum concentrations. poses dilemma atypical presentations mimicking other disease states such diabetic ketoacidosis, delirium, cerebrovascular accident, myocardial infarction cardiac failure. should borne mind an patient presents recent deterioration activities daily living no known cause. Plasma concentrations measured if suspected, even there documented ingestion. nephrotoxicity also upper gastrointestinal haemorrhage associated mortality age groups. Treatment consists prompt recognition intoxication, activated charcoal, correction acid-base abnormalities, general supportive measures, extremely high, dialysis effectively used. toxicity, marginally concentrations, treated withdrawal therapy. averted prescription conservative drug, avoidance concomitant different preparations, monitoring guide dosage. Renal function monitored detect from chronic regularly screened evidence bleeding.(ABSTRACT TRUNCATED AT 400 WORDS)