Salicylate toxicity increases CNS utilization of glucose, serum glucose levels may not reflect CNS levels.Direct toxicity of salicylate species in the CNS.As pH drops more ASA is uncharged able to cross BBB.Normal AG does not exclude ASA toxicity in patient with an unknown ingestion (mixed picture).Leads to compensatory alkaluria: urinary excretion of potassium and sodium bicarb.If have respiratory acidosis, consider: pulmonary edema, co-ingestion of respiratory depressant or fatigue.Activates respiratory center of medulla.May cause metabolic alkalosis (contraction alkalosis).As level rises, switches from hepatic to renal clearance (slower). Uncouples oxidative phosphorylation → increased metabolic rate and hyperthermia
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