A patient overdosed on aspirin several hours ago and is brought to the emergency department. The nurse assists with supportive care and then asks the provider about an order for which drug?
a. Activated charcoal
b. Ammonium chloride
c. Fomepizole [Antizol]
d. Sodium bicarbonate
D
Sodium bicarbonate is indicated for a patient who has toxic levels of aspirin. It acts by creating an alkaline urine, which reduces passive reabsorption of acids such as aspirin and accelerates its excretion. Activated charcoal is not effective after hours have passed. Ammonium chloride makes the urine more acidic. Fomepizole is used for ethylene glycol ingestion.
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