title: [Successful therapy of salicylate poisoning using glycine and activated charcoal].
abstract: Acute intoxications with salicylates are common. In a dosage of 150-300 mg/kg they are severe, and above 500 mg/kg potentially fatal. To commit suicide 4 patients ingested 375-460 mg/kg acetylsalicylic acid; 3-8 hours after ingestion salicylate blood levels of up to 760 mg/l were observed. The patients were treated for a period of 16 hours with oral charcoal and glycine (1 g/kg initially, followed every 4 hours by 0.5 g/kg, and 8 g initially, followed by 4 g, respectively). To increase urinary pH (7-9) they received i.v. NaHCO3. Blood levels of salicylic acid including its metabolites dropped initially with a virtual half-life of 2-4 hours. 18 hours after hospital admission every patient was in good general condition; none of them required hemodialysis. The urinary excretion of total salicylate reached only 6-14% of the dose within the first 12 hours of therapy, clearly indicating the importance of combined therapy with glycine and charcoal in achieving a good clinical outcome.
authors.affiliation: Spitalapotheke, Kantonsspital Aarau.
authors.forename: S
authors.initials: S
authors.lastname: Mühlebach
authors.forename: P
authors.initials: P
authors.lastname: Steger
authors.forename: D
authors.initials: D
authors.lastname: Conen
authors.forename: P A
authors.initials: PA
authors.lastname: Wyss
mesh_terms: D000328:Adult; D001241:Aspirin / Q000506:poisoning*; D002606:Charcoal / Q000627:therapeutic use*; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011041:Poisoning / Q000188:drug therapy; D012459:Salicylates / Q000097:blood / Q000652:urine; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D012459:Salicylates; D002606:Charcoal; D001241:Aspirin; D005998:Glycine