Which of the following is the most approprate therapy for an individual who has ingested an overdose of aspirin –
**Core Concept**
Aspirin overdose leads to accumulation of salicylate, causing metabolic acidosis, tinnitus, and potentially fatal cerebral edema. The treatment involves gastric decontamination, supportive care, and specific antidote administration to counteract the toxic effects of salicylates.
**Why the Correct Answer is Right**
Activated charcoal is administered to prevent further absorption of salicylates from the gastrointestinal tract. However, in cases of significant overdoses, the mainstay of treatment involves administering intravenous sodium bicarbonate to help alkalinize the blood and urine, thereby increasing the renal excretion of salicylates. This is crucial in reducing the toxic effects of salicylates on the central nervous system and other organs.
**Why Each Wrong Option is Incorrect**
**Option A:** Gastric lavage is not recommended due to the risk of aspiration and the fact that it does not effectively remove a significant amount of aspirin from the stomach.
**Option B:** Atropine is used to treat bradycardia and bronchospasm caused by organophosphate poisoning, not aspirin overdose.
**Option C:** Fomepizole is used to treat methanol and ethylene glycol poisoning, not aspirin overdose.
**Clinical Pearl / High-Yield Fact**
In cases of salicylate toxicity, administration of sodium bicarbonate can also help to alleviate respiratory alkalosis by increasing the ventilation rate, thereby reducing the severity of acid-base disturbances.
**Correct Answer: C. Sodium bicarbonate administration.