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Aspirin poisoning can be avoided

Aspirin poisoning can be avoided

A person weighing about 70 kilos would have to consume more than 30 tablets of 325 milligrams to develop even mild poisoning. An aspirin over-dose, therefore, is seldom accidental. 

Gradual aspirin poisoning can develop unintentionally by taking aspirin repeatedly at much lower doses. Children with fever who are given only slightly higher than the prescribed dose of aspirin for several days may develop poisoning.  

It should be noted that in most cases, doctors and clinicians prescribe paracetamol (panadol) for fever rather than aspirin. On very special occasions aspirin may be the best pain reliever and lower temperature if given on the definite prescribed dosage.

Conditions like Kawasaki disease in children, rheumatic fever and in sickle cell disease crisis, aspirin will be worth prescribed but sparingly taking into considerations other side effects if any noted.  

Adults, many of them elderly, can develop poisoning gradually after several weeks of use. The dosage of aspirin recommended to people with coronary artery disease to reduce the risk of heart attack ( one baby aspirin of 75 mg, ½ of an adult aspirin, or 1 full adult aspirin daily) is too small to cause gradual poisoning.  The most toxic form of salicylate is oil of wintergreen (methyl salicylate).

Methyl salicylate is a component of products such as liniments and solutions used in hot vaporizers. A young child can die from swallowing less than 1 teaspoonful of pure methyl salicylate.  Far less toxic are over the counter products containing bismuth subsalicylate (used to treat infections of the digestive tract), which can cause poisoning after several doses. To be on the safer side keeps all drugs out of reach of children and stores your drugs in locked drawers or cupboards.  

The trend now is to manufacture drugs with secure lids difficult to be opened by children. Symptoms: The first symptoms of rapid aspirin poisoning are usually nausea and vomiting followed by rapid breathing, ringing in ears, sweating and sometimes fever.   Later, if poisoning is severe, the person can develop light-headed-ness, drowsiness, confusion, seizures (convulsions) and difficult breathing.  The symptoms of gradual aspirin poisoning develop over days or weeks.

Drowsiness, confusion and hallucinations (day dreaming conditions of seeing objects which are not real, like snakes, ducks, people, etc) are the most common symptoms. Light-headedness, rapid breathing and shortness of breath can develop.  Diagnosis and treatment All poisons if need to be investigated, must be sent to Chief Government Chemist Laboratory Agency for analysis, however, in some hospital teaching laboratories within the department of biochemistry and toxicology such specimens can be analyzed.  

A blood sample is taken to measure the precise level of aspirin in the blood. Measurement of the blood pH and the level of carbon dioxide or bicarbonate in the blood also can help to determine the severity of poisoning.   Tests are usually repeated during treatment to reveal whether the person is recovering. Prevention is better than cure, it is with this concept in mind that the community should prevent especially and in particular children from ingesting any form of medicine or poison, be it kerosene or insecticide. 

Activated charcoal reduces aspirin absorption. For moderate or severe poisoning, fluids containing sodium bicarbonate are given intravenously; unless there is kidney damage, potassium is added to the fluid.   This mixture moves aspirin from the blood stream into the urine. If the person’s condition is worsening despite other treatments, haemodialysis can remove aspirin from the blood. Vitamin K may be given to treat bleeding problems. 

Aspirin should not be used in a woman who is about to deliver, it delays contraction of the uterus. The same drug could be used in pregnant mothers who have threatened abortion, as possible means of delaying contractions.   There is no self prescription to these matters, it is better for the doctor to make the prescription for the patient. In another different note aspirin may cause asthma attack in people who are already asthmatic.

The asthmatic woman benefits from salbutamol if she has premature labour.  Aspirin is not given to children with influenza, measles and chickenpox because they could develop a condition known as Reye’s syndrome. Reye’s syndrome is a very rare but life threatening disorder that causes inflammation and swelling of the brain and degeneration of the liver.  

I may say sometimes in the villages or in urban setting where paracetamol is missing, aspirin may be given cautiously as long as it is not a case of measles or chickenpox.  Aspirin should not be taken on an empty stomach in normal circumstances and should not be given to people with history of peptic ulcers, as it may cause ulceration of stomach mucosa to cause bleeding.  


Author: Dr Ali Mzige

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