goodies
Forum Junior
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When you overdose on aspirin, respiratory alkalosis occurs and eventually metabolic acidosis. Does respiratory acidosis ever occur? Can someone please explain this because I don't really understand the sequence of events.
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| epica
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Toxicity increased in children;
when inhibitts respirat center---respiration decreased. incr pco2---decreased Ph and Hco3---Respirat acidos, later in severe---metab. acidosis ( decreased ATP)
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| shalini.ravi
Forum Senior
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when u give asprin- stimulation of respiratory center,throw out CO2
DECREASE IN PC02-DECREASE CARBONICA ACID,SO alkalosis (repi alkalosis) and then salicylate will uncouple oxidative phosphorylation,lactic acidosis and salicylate itself is an acid so all the hco3- is used up to bufeer the acid and u hv decrease hco3- so ph goes down and its metabolic acidosis...hope this helps!
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| shalini.ravi
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salicylate stimulates the respiratory center epica i dont think it inhibits it even in children...ingibitors of respiratory center are barbiturates,narcotics and cns trauma....these depress the cns respiratory medullary center 
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| new_n_lost
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Yup thats i chked it Salicylates Excite the Respiratory Centers. which also suprised me at first.
In salicylate toxicity, as salicylate levels increase, the acid-base disturbance progresses from respiratory alkalosis to mixed respiratory alkalosis and metabolic acidosis. In children, the progression to metabolic acidosis occurs more rapidly. Salicylates directly stimulate respiratory centers in the medulla, causing hyperventilation and, subsequently, respiratory alkalosis. Salicylates also cause the uncoupling of oxidative phosphorylation, which leads to decreased adenosine triphosphate production, increased oxygen consumption, increased carbon dioxide production, and increased heat production. Derangement in the Krebs cycle and in carbohydrate metabolism leads to an accumulation of organic acids, including pyruvate, lactate, and acetoacetate, causing metabolic acidosis.
Toxic levels of salicylates also displace large amounts of plasma bicarbonate, worsening the metabolic acidosis. The metabolic acidosis in salicylate poisoning is an anion gap acidosis, Na+ - (Cl- +HCO3-) greater than 14 mEq/L. Other causes of anion gap metabolic acidosis that can be confused with or can coexist with salicylate toxicity include diabetic ketoacidosis, renal failure, lactic acidosis, and volatile alcohol overdose (methanol, ethylene glycol).
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| new_n_lost
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Furthermore, a severe metabolic (ketolactic) acidosis with compensatory respiratory alkalosis may develop with severe salicylate intoxication. A paradoxical aciduria (hydrogen ion excretion) occurs with the depletion of sodium bicarbonate and potassium.
Infants rarely present with a pure respiratory alkalosis. Respiratory alkalosis with a compensatory (high anion gap) metabolic acidosis defines the next stage in moderate-to-severe intoxication. Potassium moves from the intracellular space to the extracellular space. Excretion of hydrogen ions produces acidic urine
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| shalini.ravi
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awesome!
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| epica
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Goodies asked the Q " Does respirat acidosis ever occur in ASA?
The ans is "Yes" in severe cases (esp in children)
From Merk Manual.
Hyperactivity may quickly turn to lethargy; hyperventilation (with respiratory alkalosis) changes to hypoventilation (with mixed RESPIRATORY and metabolic acidosis) and respiratory failure.
http://www.merck.com/mmpe/print/sec21/ch326/ch326...
Also Kaplan gave the same explanation.
Shalini, please look up Kaplan Pharma.
Guys, please correct me if I am wrong
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| new_n_lost
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Yup U r Right It does occur in Children but in rarity n very severe cases
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