How is the excretion of salicylate increased in the treatment of metabolic acidosis?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Increasing urine pH increases the excreted salicylate. Alkaline diuresis can be initiated by intravenous NaHCO3 administration or by acetazolamide therapy. The goal is to maintain the urine pH at greater than 7.5 until the salicylate level falls below 30-50 mg/dL.

Multiple dosing of activated charcoal at 0.25-1 g/kg every 2-4 hours can also be used to increase the excretion of salicylate.


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