Introduction - Uppsala Monitoring Centre

dose Aspirin produces generally its maximum effect… it has been possible to state
the complete innocuity of the medication; of 43 patients, two only have not tolerated
it because it provoked a loss of appetite and a heaviness of the stomach; but they
were two badly affected cardiac patients who could not tolerate any medicine and
even had difficulty with milk…We can confirm that there was a slight increase in
blood pressure in the hour and during 4 hours following its ingestion… We have
nothing to reproach this medicine, concerning side effects, no gastric pain, no
tinnitus. Only sweating has been established, sometimes considerable. (see
comments in 1899).
Patient Information leaflet (UK 2004)
Side effects: irritation to or bleeding of the stomach, difficulty breathing or asthma
attacks in patients with a history of these, and allergic skin reactions. There is no
mention of the most likely symptoms of salicylicism with high doses. This is minimal
information, but does cover the most important ADRs at normal doses.
Summary of Product Characteristics (SPC) Electric Medicines
Compendium: Boots Aspirin
Dyspepsia, nausea, vomiting. Less commonly irritation of the gastrointestinal
mucosa may lead to erosion, ulceration, gastrointestinal bleeding. Hepatotoxicity,
which occurs rarely.
Hypersensitivity reactions including urticaria, rhinitis, angioneurotic oedema and
severe bronchospasm.
Aspirin may cause salt and water retention as well as a deterioration in renal
function.
Overdose
Salicylate poisoning is usually associated with plasma concentrations>350mg.L (2.5
mmol/L). Most adult deaths occur in patients whose concentrations exceed 700
mg/L (5.1mmol/L). Single doses less than 100mg/kg are unlikely to cause serious
poisoning.
Common features of salicylate poisoning include vomiting, dehydration, tinnitus,
vertigo, deafness, sweating, warm extremities with bounding pulses, increased
respiratory rate and hyperventilation. Some degree of acid-base disturbance is
present in most cases.
A mixed respiratory alkalosis and metabolic acidosis with normal or high arterial
pH (normal or reduced hydrogen ion concentration) is usual in adults and children
over the age of 4 years. In children aged 4 years or less, a dominant metabolic
acidosis with low arterial pH (raised hydrogen ion concentration) is common.
Acidosis may increase salicylate transfer across the blood brain barrier.
Uncommon features of salicylate poisoning include haematemesis, hyperpyrexia,