Salicylates - TTAPS



SALICYLATE TOXICITYWith Paradoxical (compensatory) alkaluriaSalicylates are ubiquitous agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs, making salicylate toxicity an important cause of morbidity (sickness) and mortality (death).Ingestion of topical products containing salicylates, such as Ben-Gay, salicylic acid (keratolytic), and oil of wintergreen or methyl salicylate, can cause severe salicylate toxicity. One teaspoon of 98% methyl salicylate contains 7000 mg of salicylate, the equivalent of nearly 90 baby aspirins and more than 4 times the potentially toxic dose for a child who weighs 10 kg. Salicylate toxicity has been reported with the topical use of salicylate-containing teething gels in infants. The prevalence of alternative medicines and the popularity of herbs and traditional medicine formulae are increasing in North America. Many of these medicines may contain salicylate. Therefore, consider salicylate poisoning when topical herbal medicinal oil is involved. Phases and symptoms of salicylate toxicityPhase 1 of the toxicity is characterized by hyperventilation resulting from direct respiratory center stimulation, leading to respiratory alkalosis and compensatory alkaluria. Potassium and sodium bicarbonate are excreted in the urine. This phase may last as long as 12 hours. In phase 2, paradoxic aciduria in the presence of continued respiratory alkalosis occurs when sufficient potassium has been lost from the kidneys. This phase may begin within hours and may last 12-24 hours.Phase 3 includes dehydration, hypokalemia, and progressive metabolic acidosis. This phase may begin 4-6 hours after ingestion in a young infant or 24 hours or more after ingestion in an adolescent or adult. Nausea, vomiting, diaphoresis, and tinnitus are the earliest signs and symptoms of salicylate toxicity. Other early symptoms and signs are vertigo, hyperventilation, tachycardia, and hyperactivity. As toxicity progresses, agitation, delirium, hallucinations, convulsions, lethargy, and stupor may occur. Hyperthermia is an indication of severe toxicity, especially in young children.SALICYLATE ALLERGYSalicylates are chemicals found naturally in plants and are a major ingredient of aspirin and other pain-relieving medications. They are also found in many fruits and vegetables as well as in many common health and beauty products.What Are the Symptoms of a Salicylate Allergy?The degree of reaction to salicylates can vary based on multiple factors. Typically, the content of salicylates can vary from one item to another and even among batches of the same item from the same source. Additionally, the degree of salicylate sensitivity can vary from person to person. People with ?a low salicylate tolerance may have an allergic reaction if more than a small amount of salicylate is consumed. Symptoms of a salicylate allergy vary but may include:Asthma-like symptoms, such as trouble breathing and wheezingHeadachesNasal congestionChanges in skin colorItching, skin rash, or hivesSwelling of the hands, feet, and faceStomach painIn severe cases, a salicylate allergy can lead to anaphylaxis, a life-threatening reaction involving a severe drop in blood pressure, loss of consciousness, and organ system failure. Avoiding products that contain salicylates is the best defense against an allergic reaction.Salicylates can be found in a variety of foods, medications, and cosmetics. Some examples of salicylate-containing substances include:Foods That Contain Salicylates Products That May Contain Salicylates Salicylate-Containing Ingredients Fruits such as apples, avocados, blueberries, dates, kiwi fruit, peaches, raspberries, figs, grapes, plums, strawberries, cherries, grapefruit, and prunesVegetables such as alfalfa, cauliflower, cucumbers, mushrooms, radishes, broad beans, eggplant, spinach, zucchini, broccoli, and hot peppersSome cheesesHerbs, spices, and condiments such as dry spices and powders, tomato pastes and sauces, vinegar, and soy sauce, jams, and jelliesBeverages such as coffee, wine, beer, orange juice, apple cider, regular and herbal tea, rum, and sherryNuts such as pine nuts, peanuts, pistachios, and almondsSome candies, such as peppermints, licorice, and mint-flavored gum and breath mintsIce cream, gelatin?Fragrances and perfumesShampoos and conditionersHerbal remediesCosmetics such as lipsticks, lotions, and skin cleansersMouthwash and mint-flavored toothpasteShaving creamSunscreens or tanning lotionsMuscle pain creamsAlka Seltzer?AspirinAcetylsalicylic acidArtificial food coloring and flavoringBenzoatesBeta-hydroxy acidMagnesium salicylateMentholMintSalicylic acidPeppermintPhenylethyl salicylateSodium salicylateSpearmint? ................
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