Aspirin and Nonsteroidal Agents

The incidence of aspirin (acetylsalicylic acid [ASA]) overdose and related childhood deaths has decreased significantly in recent years. Reasons include pediatricians’ preference for acetaminophen preparations, the Food and Drug Administration’s mandate limiting 36 tablets of baby aspirin to each bottle, and the use of child-resistant caps. Unfortunately, the severity of this poisoning may be underestimated because of the lack of familiarity with the clinical picture. Salicylate toxicity can cause metabolic acidosis, seizure, hyperthermia, pulmonary edema, cerebral edema, renal failure, and death. Morbidity and mortality are increased by delayed diagnosis in elderly patients with chronic medical problems and in young patients diagnosed with an acute illness.