ASA overdose and electrolytes

 Q: Which of the following electrolyte abnormality should be treated aggressively in salicylate overdose?

A) Hyponatremia

B) Hypernatremia

C) Hypokalemia

D) Hyperkalemia

E) Hypocalcemia

Answer: C

Hypokalemia should be treated aggressively in salicylate poisoning. The presence of hypokalemia enhances the activity of the K+/H+ exchange pump in the distal tubule. This increases the absorption of potassium with excretion of H+ ion in the urine. This compromises any effort by a clinician to alkalinize the urine which is the mainstay of treatment in salicylate poisoning. In the presence of hypokalemia, treatment becomes ineffective.

#toxicology

Reference:

American College of Medical Toxicology. Guidance document: management priorities in salicylate toxicity. J Med Toxicol. 2015;11(1):149-152. doi:10.1007/s13181-013-0362-3