aspirin posioning qs

[match2011]

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26y woman ingesting 50 tablets of aspirin in a suicide attemp. nauseated, confused, and sleepy. pulse 130bp, rr 30bp, Bp 100/60

I thought it is acute res alk, so the PH increase, Hco3 increase and pco2 decrease

but the answer is : decreased PH, Hco3 and pco2

why?

 

[rmsgolfer]

As far as I can remember the overdose will first stimulate respiratory centers so the alkalosis occurs first (shortly), then acidosis predominates as ASA is an acid. So pH would be decreased, CO2 would also be decreased, and acutely HCO3 would be low because the kidney takes a while to figure out whats going on and retain HCO3.

 

[FutureInternist]

Aspirin is an Acid. So you have compensatory respiratory alkalosis, but you're still acidotic. So pH is down, Bicarb is down, and PCO2 is down.

I think...

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As far as I can remember the overdose will first stimulate respiratory centers so the alkalosis occurs first (shortly), then acidosis predominates as ASA is an acid. So pH would be decreased, CO2 would also be decreased, and acutely HCO3 would be low because the kidney takes a while to figure out whats going on and retain HCO3.

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