An experimental study of salicylate poisoning in young dogs was used to investigate the relative efficacy of water diuresis (group 1), bicarbonate (group 2), and acetazolamide plus bicarbonate (group 3) as therapy for salicylate poisoning.
Blood salicylate levels fell at about the same rate in all three groups. Urinary salicylate excretion and pH increased rapidly following acetazolamide, with a three-hour delay after bicarbonate, and did not increase at all with water diuresis. The latter animals became progressively acidotic until death. Of nine animals in each group, two survived in group 1, six in group 2, eight in group 3.
While the rapid action of acetazolamide favors its use in the treatment of salicylate poisoning, the profound acidosis present in most children precludes its immediate administration.
Reimold EW, Worthen HG, Reilly TP. Salicylate Poisoning: Comparison of Acetazolamide Administration and Alkaline Diuresis in the Treatment of Experimental Salicylate Intoxication in Puppies. Am J Dis Child. 1973;125(5):668–674. doi:10.1001/archpedi.1973.04160050022005
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