S. Muhlebach et al., SUCCESSFUL TREATMENT OF ACUTE SALICYLATE POISONING WITH GLYCINE AND CHARCOAL, Schweizerische medizinische Wochenschrift, 126(49), 1996, pp. 2127-2129
Acute intoxications with salicylates are common. In a dosage of 150-30
0 mg/kg they are severe, and above 500 mg/kg potentially fatal. To com
mit suicide 4 patients ingested 375-460 mg/kg acetylsalicylic acid; 3-
8 hours after ingestion salicylate blood levels of up to 760 mg/l were
observed. The patients were treated for a period of 16 hours with ora
l charcoal and glycine (1 g/kg initially, followed every 4 hours by 0.
5 g/kg, and 8 g initially, followed by 4 g, respectively). To increase
urinary pH (7-9) they received i.v. NaHCO3. Blood levels of salicylic
acid including its metabolites dropped initially with a virtual half-
life of 2-4 hours. 18 hours after hospital admission every patient was
in good general condition; none of them required hemodialysis. The ur
inary excretion of total salicylate reached only 6-14% of the dose wit
hin the first 12 hours of therapy, clearly indicating the importance o
f combined therapy with glycine and charcoal in achieving a good clini
cal outcome.