Salicylate Toxicity Questions & Answers

1. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, et al. 2020 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021 Dec. 59 (12):1282-1501. [QxMD MEDLINE Link]. [Full Text].

2. Madan RK, Levitt J. A review of toxicity from topical salicylic acid preparations. J Am Acad Dermatol. 2014 Apr. 70 (4):788-92. [QxMD MEDLINE Link].

3. Pearlman BL, Gambhir R. Salicylate intoxication: a clinical review. Postgrad Med. 2009 Jul. 121(4):162-8. [QxMD MEDLINE Link].

4. Mund ME, Gyo C, Brüggmann D, Quarcoo D, Groneberg DA. Acetylsalicylic acid as a potential pediatric health hazard: legislative aspects concerning accidental intoxications in the European Union. J Occup Med Toxicol. 2016. 11:32. [QxMD MEDLINE Link].

5. Tidy C. Salicylate Poisoning. Patient.info. Available at https://patient.info/doctor/salicylate-poisoning. 22 May 2014; Accessed: June 6, 2020.

6. Ellenhorn MJ, Barceloux DG. Medical Toxicology: Diagnosis and Treatment of Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc; 1988. 562.

7. Williams GD, Kirk EP, Wilson CJ, Meadows CA, Chan BS. Salicylate intoxication from teething gel in infancy. Med J Aust. 2011 Feb 7. 194(3):146-8. [QxMD MEDLINE Link].

8. Greene T, Rogers S, Franzen A, Gentry R. A critical review of the literature to conduct a toxicity assessment for oral exposure to methyl salicylate. Crit Rev Toxicol. 2016 Nov 11. 1-23. [QxMD MEDLINE Link].

9. Davis JE. Are one or two dangerous? Methyl salicylate exposure in toddlers. J Emerg Med. 2007 Jan. 32(1):63-9. [QxMD MEDLINE Link].

10. Arriola K, Cantrell L. Risk of toxicity from pediatric topical salicylate ingestions. Clin Toxicol (Phila). 2021 Jul. 59 (7):655-657. [QxMD MEDLINE Link].

11. Lewis TV, Badillo R, Schaeffer S, Hagemann TM, McGoodwin L. Salicylate toxicity associated with administration of Percy medicine in an infant. Pharmacotherapy. 2006 Mar. 26(3):403-9. [QxMD MEDLINE Link].

12. Rose SR, Cumpston KL, Kim J, Difranco D, Wills BK. Absorption of salicylate powders versus tablets following overdose: a poison center observational study. Clin Toxicol (Phila). 2016 Jul 6. 1-5. [QxMD MEDLINE Link].

13. Stolzberg D, Salvi RJ, Allman BL. Salicylate toxicity model of tinnitus. Front Syst Neurosci. 2012. 6:28. [QxMD MEDLINE Link]. [Full Text].

14. Rauschka H, Aboul-Enein F, Bauer J, Nobis H, Lassmann H, Schmidbauer M. Acute cerebral white matter damage in lethal salicylate intoxication. Neurotoxicology. 2007 Jan. 28(1):33-7. [QxMD MEDLINE Link].

15. Hamdan JA, Manasra K, Ahmed M. Salicylate-induced hepatitis in rheumatic fever. Am J Dis Child. 1985 May. 139(5):453-5. [QxMD MEDLINE Link].

16. Hatten BW, Hendrickson RG. Coagulopathy and bleeding associated with salicylate toxicity. Clin Toxicol (Phila). 2020 Jan. 58 (1):16-19. [QxMD MEDLINE Link].

17. Chen GD, Stolzberg D, Lobarinas E, Sun W, Ding D, Salvi R. Salicylate-induced cochlear impairments, cortical hyperactivity and re-tuning, and tinnitus. Hear Res. 2013 Jan. 295:100-13. [QxMD MEDLINE Link].

18. Waasdorp Hurtado CE, Kramer RE. Salicylic acid ingestion leading to esophageal stricture. Pediatr Emerg Care. 2010 Feb. 26(2):146-8. [QxMD MEDLINE Link].

19. Hatten BW, Hendrickson RG. Coagulopathy and bleeding associated with salicylate toxicity. Clin Toxicol (Phila). 2020 Jan. 58 (1):16-19. [QxMD MEDLINE Link].

20. Haslinger V, Dietz W, Bartsch M, Simma B. Salicylate intoxication with symptoms of septicaemia in a 17-month-old girl. Klin Padiatr. 2011 Dec. 223(7):436-7. [QxMD MEDLINE Link].

21. Moss MJ, Fisher JA, Kenny TA, Palmer AC, Thompson JA, Wolfer H, et al. Salicylate toxicity after undetectable serum salicylate concentration: a retrospective cohort study. Clin Toxicol (Phila). 2019 Feb. 57 (2):137-140. [QxMD MEDLINE Link].

22. Rumack BH, Matthew H. Acetaminophen poisoning and toxicity. Pediatrics. 1975 Jun. 55(6):871-6. [QxMD MEDLINE Link].

23. Kuzak N, Brubacher JR, Kennedy JR. Reversal of salicylate-induced euglycemic delirium with dextrose. Clin Toxicol (Phila). 2007 Jun-Aug. 45(5):526-9. [QxMD MEDLINE Link].

24. Beauchamp GA, Hendrickson RG. Delayed Salicylate Toxicity in a 17-Year-Old Girl With Initially Undetectable Salicylate Concentration 3.9 Hours After Ingestion. Pediatr Emerg Care. 2016 Sep 30. [QxMD MEDLINE Link].

25. [Guideline] Chyka PA, Erdman AR, Christianson G, Wax PM, Booze LL, Manoguerra AS, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007. 45(2):95-131. [QxMD MEDLINE Link].

26. McCabe DJ, Lu JJ. The association of hemodialysis and survival in intubated salicylate-poisoned patients. Am J Emerg Med. 2017 Jun. 35 (6):899-903. [QxMD MEDLINE Link].

27. Kirshenbaum LA, Mathews SC, Sitar DS, Tenenbein M. Does multiple-dose charcoal therapy enhance salicylate excretion?. Arch Intern Med. 1990 Jun. 150(6):1281-3. [QxMD MEDLINE Link].

28. Kirshenbaum LA, Mathews SC, Sitar DS, Tenenbein M. Whole-bowel irrigation versus activated charcoal in sorbitol for the ingestion of modified-release pharmaceuticals. Clin Pharmacol Ther. 1989 Sep. 46(3):264-71. [QxMD MEDLINE Link].

29. Thanacoody R, Caravati EM, Troutman B, Höjer J, Benson B, Hoppu K, et al. Position paper update: whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol (Phila). 2015 Jan. 53 (1):5-12. [QxMD MEDLINE Link].

30. Proudfoot AT, Krenzelok EP, Brent J, Vale JA. Does urine alkalinization increase salicylate elimination? If so, why?. Toxicol Rev. 2003. 22(3):129-36. [QxMD MEDLINE Link].

31. Ong GY. A simple modified bicarbonate regimen for urine alkalinization in moderate pediatric salicylate poisoning in the emergency department. Pediatr Emerg Care. 2011 Apr. 27(4):306-8. [QxMD MEDLINE Link].

32. Juurlink DN, Gosselin S, Kielstein JT, Ghannoum M, Lavergne V, Nolin TD, et al. Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Ann Emerg Med. 2015 Aug. 66 (2):165-81. [QxMD MEDLINE Link].

33. Papacostas MF, Hoge M, Baum M, Davila SZ. Use of continuous renal replacement therapy in salicylate toxicity: A case report and review of the literature. Heart Lung. 2016 Sep-Oct. 45 (5):460-3. [QxMD MEDLINE Link].

34. Herres J, Ryan D, Salzman M. Delayed salicylate toxicity with undetectable initial levels after large-dose aspirin ingestion. Am J Emerg Med. 2009 Nov. 27(9):1173.e1-3. [QxMD MEDLINE Link].

35. Chyka PA, Erdman AR, Christianson G, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007. 45(2):95-131. [QxMD MEDLINE Link].

Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA Professor of Emergency Medicine and Clinical Pediatrics, Weill Cornell Medical College; Attending Physician, Departments of Emergency Medicine and Pediatrics, Lincoln Medical and Mental Health Center; Adjunct Professor of Emergency Medicine, Adjunct Professor of Pediatrics, St George's University School of Medicine, Grenada

Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA is a member of the following medical societies: American Academy of Pediatrics, American Academy of Urgent Care Medicine, American College of Emergency Physicians, American Heart Association, American Medical Association, Association of Clinical Research Professionals, Public Responsibility in Medicine and Research, Society for Academic Emergency Medicine, Society for Simulation in Healthcare

Disclosure: Nothing to disclose.

Muhammad Aslam, MD Professor of Pediatrics, University of California, Irvine, School of Medicine; Neonatologist, Division of Newborn Medicine, Department of Pediatrics, UC Irvine Medical Center

Muhammad Aslam, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Joel R Gernsheimer, MD, FACEP Visiting Associate Professor, Department of Emergency Medicine, Attending Physician and Director of Geriatric Emergency Medicine, State University of New York Downstate Medical Center

Joel R Gernsheimer, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Geriatrics Society

Disclosure: Nothing to disclose.

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Fred Harchelroad, MD, FACMT, FAAEM, FACEP Chair, Department of Emergency Medicine, Director of Medical Toxicology, Allegheny General Hospital; Associate Professor, Department of Emergency Medicine, Drexel University College of Medicine

Disclosure: Nothing to disclose.

Lance W Kreplick, MD, FAAEM, MMM Medical Director of Hyperbaric Medicine, Fawcett Wound Management and Hyperbaric Medicine; Consulting Staff in Occupational Health and Rehabilitation, Company Care Occupational Health Services; President and Chief Executive Officer, QED Medical Solutions, LLC

Lance W Kreplick, MD, FAAEM, MMM, is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physician Executives

Disclosure: Nothing to disclose.

Michael E Mullins, MD Assistant Professor, Division of Emergency Medicine, Washington University in St Louis School of Medicine; Attending Physician, Emergency Department, Barnes-Jewish Hospital

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology and American College of Emergency Physicians

Disclosure: Johnson & Johnson stock ownership None; Savient Pharmaceuticals stock ownership None

Mark S Slabinski, MD, FACEP, FAAEM Vice President, EMP Medical Group

Mark S Slabinski, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, and Ohio State Medical Association

Disclosure: Nothing to disclose.

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut School of Medicine, Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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