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Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Methyl salicylate is rapidly absorbed from the gastrointestinal tract. Much of the ester is hydrolyzed to free salicylate. The onset of symptoms is rapid, usually within 2 hours of ingestion. Clinical manifestations are similar to those observed with poisoning by other salicylates. However, in view of its lipid solubility, methyl salicylate is expected to be more toxic. The major toxic effects of salicylates may be grouped as gastrointestinal, central nervous system, hematological, and metabolic and acid-base disturbances. In adult patients with severe salicylate poisoning, delayed presentation, coma, hyperpyrexia, and pulmonary edema and acidemia appear to be more common among the fatal cases (12).
A 29-year analysis of acute peak salicylate concentrations in fatalities reported to United States poison centers
Published in Clinical Toxicology, 2018
Brandon J. Warrick, Andrew King, Susan Smolinske, Ronald Thomas, Cynthia Aaron
Since salicylate poisoning affects multiple organ systems and biochemical processes, clinicians should not rely solely on salicylate concentrations in the acutely poisoned patient. Instead, clinicians should factor in a number of patient-specific and physiologic parameters to determine the appropriate threshold to initiate extracorporeal removal. Both the recent EXTRIP expert consensus paper and American College of Medical Toxicology (ACMT) guideline discuss these parameters [2,3]. Both guidelines appropriately stress the importance of physical findings and patient physiology when determining need for dialysis including the presence of altered mental status, new hypoxia requiring supplemental oxygen, renal impairment, failure of standard therapy (i.e., sodium bicarbonate urine alkalinization), and acidosis. However, both guidelines employ 100 mg/dL as a reference threshold for initiating extracorporeal removal. As these manuscripts are based on an analysis of available cases and expert opinion, a lack of robust data limit the strength of these recommendations.
Risk of toxicity from pediatric topical salicylate ingestions
Published in Clinical Toxicology, 2021
Most patients had no reported symptoms (433 cases, 69%). Mild symptoms [6,7] included oral irritation and nausea/vomiting/gastrointestinal distress (118, 19%), sedation (17, 2.8%), and agitation (12%). Side effects consistent with significant salicylate poisoning were reported in 6 cases (1%). This included metabolic acidosis (1) and tachypnea (5). The lowest reported serum bicarbonate level was 10 mEq/L (no pH is given). Lowest reported CO2 was 15 mEq/L (pH of 7.37).