Salicylates inhibit the citric acid cycle and uncouple oxidative phosphorylation. Inhibition of these ATP-dependent processes results in:
- Increased O2 consumption
- Increased CO2 production
- Enhanced glycolytic and lipolytic metabolism
- Depletion of hepatic glycogen
Effects on Acid-Base Status
Effects of salicylate toxicity vary based on the dose and age of the patient. Direct stimulation of respiratory centers results in a respiratory alkalosis initially. In mild cases, this may be the only acid-base manifestation. Infants, however, rarely presents with mild cases. In severe cases, however, a dire metabolic (ketolactic) acidosis develops. There is a compensatory respiratory alkalosis and the development of a paradoxical aciduria.