Posts Tagged “Pharmacy”

A 60 year old woman with newly diagnosed rheumatoid arthritis complains of fever and ringing inher ears. One month ago she was started on three (3) 325 mg aspririn tablets three times a day after meals. One week ago she was still symptomatic. Blood salicylate levels were measured at 10 mg/dL. She was instructed to increase the dosage to four (4) 325 mg tablets three times a day after meals. Objective data: Confused, febrile woman with tachypenea and arthritic changes constistent with rheumatoid arthriti. Plasma salicylate level is 100 mg/dL. Plasma electrolytes are consisten with metabolic acidosis.
A. At low doses, aspirin is eliminatd by first order kinetics. At higher doses, aspirin is eliminatd by zero order kinetics. Why did the plasma concentration of salicylate increase 10 fold when the dose of the drug increased only 1.3 fold?
B. The pka of aspirin is 3.5. What could you do to speed up the elimination of the drug from the body so the patient is no longer intoxicated?

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