Question..............Aspirin Toxicity "1" - psychmledr

[ArchivalUser]

A 56-year-old man is admitted to the Emergency Department after ingesting a large dose of aspirin, most of which is still within the vascular system. The patient is diaphoretic and has the following blood gases: pH of 7.45, PCO2 of 17 mmHg, and [HCO3] of 13 mmol/L. Aspirin has a pK of 3.5 and when it is in the unionized state will rapidly cross the blood-brain barrier. Which of the following treatment options would be most deleterious to this patient?

a. Gastric lavage
b. Intravenous glucose
c. Decreasing alveolar ventilation
d. Increasing fluid volume
e. Administering activated charcoal

[ArchivalUser]

CC

[ArchivalUser]

AA

[ArchivalUser]

I'll pick B..

[ArchivalUser]

C,

[ArchivalUser]

Correct answer is "C"

Alkaline pH resulting from the hyperventilation is keeping most of the aspirin in an ionized form in which it cannot easily cross the blood-brain barrier.

If the patient is intubated and placed on a ventilator to prevent muscle fatigue, it is important to maintain hyperventilation to mimic the body's compensatory response.
If ventilation is decreased as in choice "C" then more aspirin will cross the blood-brain barrier and the situation may become far worse.

Gastric lavage with isotonic saline followed by administration of activated charcoal is indicated. Excessive insensible water loss from vaporization of sweat may cause severe volume depletion, requiring fluid replacement.

Glucose should be administered to prevent and treat hypoglycemia.

[ArchivalUser]

Good points noted down.

Thanks.

[ArchivalUser]

Answer is C

[ArchivalUser]

I did not pay attention to''deleterious ''

Thank you very much