How does aspirin cause metabolic acidosis?

Aspirin directly stimulates cerebral respiratory centers and inhibits the citric acid cycle, causing uncoupling of oxidative phosphorylation which ultimately leads to lactic acidosis. Patients who present with aspirin toxicity may initially appear well before acute decompensation.

Why do salicylates cause metabolic acidosis?

The metabolism of fatty acids is likewise increased in patients with salicylate toxicity, generating ketone body formation. These processes all contribute to the development of an elevated anion-gap metabolic acidosis in patients with salicylate poisoning.

Does aspirin cause high anion gap metabolic acidosis?

Aspirin causes high anion gap metabolic acidosis and respiratory alkalosis. The high anion gap comes from the addition of salicylic acid as well as the generation of lactic acid (due to uncoupling of oxidative phosphorylation causing anaerobic respiration).

How is metabolic acidosis related to salicylate poisoning?

Eventually, as salicylates disappear from the blood, enter the cells, and poison mitochondria, metabolic acidosis becomes the primary acid-base abnormality. Salicylate poisoning also causes ketosis, fever, and, even when systemic hypoglycemia is absent, low brain glucose levels.

What happens when a person overdoses on aspirin?

Many drugs, when taken in overdose, can deleteriously affect acid-base balance, leading to abnormal arterial blood gas (ABG) results. Aspirin is one such, and perhaps because of its easy availability, one of the most common of all drugs to be taken in overdose.

How are acidosis and alkalosis determined by blood gas?

Blood Gas Interpretation – Determining Acidosis and Alkalosis. There are four classic disturbances in traditional acid-base equilibria: respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. The body tries to compensate for a primary disturbance(s) (ie, metabolic alkalosis) through one or more mechanisms (ie,…

What are the symptoms of aspirin and salicylate poisoning?

Later symptoms include hyperactivity, fever, confusion, and seizures. Rhabdomyolysis, acute renal failure, and respiratory failure may eventually develop. Hyperactivity may quickly turn to lethargy; hyperventilation (with respiratory alkalosis) progresses to hypoventilation (with mixed respiratory and metabolic acidosis) and respiratory failure.