A 23-year-old woman is brought to the emergency department after ingesting approximately 30 aspirin tablets two hours ago during an argument with her partner. She has tinnitus, tachypnea at 28 breaths per minute, and nausea with one episode of vomiting. Her temperature is 38.2°C and serum salicylate level is 65 mg/dL. Arterial blood gas shows pH 7.46 with a mixed respiratory alkalosis and metabolic acidosis. In addition to supportive care, which of the following interventions enhances excretion of the drug by trapping it in the urine?
- A)Activated charcoal to inhibit renal secretion
- B)Naloxone to reverse respiratory depression
- C)Physostigmine to increase muscarinic tone
- D)Sodium bicarbonate administration to alkalinize the urineGABARITO
- E)Ammonium chloride administration to acidify the urine
Explicação
Aspirin is a weak acid. Alkalinizing the urine with sodium bicarbonate increases ionization of the drug in tubular fluid, decreasing reabsorption and enhancing renal excretion by ion trapping. The clinical picture of salicylate toxicity makes this the appropri... Ver explicação completa e trilha adaptativa →