Categories: Drugs/Metabolism

Why Does Aspirin Overdose cause Respiratory Alkalosis

Adults: Metabolic acidosis AND Respiratory alkalosis 

Children: Metabolic acidosis ONLY. (If fasting a starvation ketosis may develop)

Respiratory Alkalosis: First phase; Direct stimulation of medullary respiratory centers by ASA. Does not happen in children [1]

Metabolic Acidosis:  Second phase; ASA toxicity causes anion gap metabolic acidosis. THIS IS NOT DUE TO ASA directly as an acid. [1]

  • Why? salicylate interrupts & uncouples oxidative phosphorylation in aerobic respiration & kerbs cycle. This results in the production of lactate. 


  1. O’Malley, Gerald F. Emergency Department Management of the Salicylate-Poisoned Patient. Emerg Med Clin N Am (2007) 25: 333-346
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Dr. C Humphreys

Internal Medicine

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