Salicylate toxicity from chronic bismuth subsalicylate use

A 79-year-old man presented to the emergency department with a 1-week history of worsening confusion, falls and hearing impairment. An initial workup for infectious, metabolic and structural causes was unrevealing. However, further history discovered that he had been ingesting one to two bottles of Pepto-Bismol (bismuth subsalicylate) daily for gastro-oesophageal reflux symptoms. On his second day of admission, the plasma salicylate concentration was 2.08 mmol/L (reference range 1.10–2.20 mmol/L), despite no sources of salicylate in hospital. He was diagnosed with chronic salicylate toxicity and Pepto-Bismol use was discontinued. The patient was treated supportively with isotonic intravenous fluids only and plasma salicylate concentration fell to less than 0.36 mmol/L. Concurrently, all his symptoms resolved. This case highlights the potential adverse effects of over-the-counter medications. The diagnosis of chronic salicylate toxicity is challenging, specifically in the elderly and in undifferentiated presentations, as it can be missed if not suspected.

Efficient Wormlike Micelles for the Controlled Delivery of Anticancer Drugs

Background: In order to improve the solubility and carrying capacity of anticancer drugs to the targeted cells a potential nanoformulation is needed Objective: A viscoelastic wormlike micelles (WLM) have been reported in the present study. Methods: The elongated and flexible aggregates of amphiphiles were formed due to the self-organization when the amphiphile concentration was fixed at its CMC and the sodium salicylate concentration was varied for the optimization Results: The stable structure, higher density, higher viscosity and potent cell killing effect at lower concentration of drug were observed at 480 μM concentration of sodium salicylate. The doxorubicin release profile showed a clear sustained release after 20 h and 82% of the drug has been released after 72 h. Conclusion: Therefore, the designed WLMs can be used as efficient drug delivery vehicle for the treatment of cancer

Extraction Studies of Lanthanum(III) from Sodium Salicylate Medium Using Trialkyl Phosphine Oxide

Cyanex-923, a mixture of four trialkylphosphine oxide has been used for the extraction and separation of La(III) from sodium salicylate medium. Lanthanum(III) ion was found to be quantitatively extracted with Cyanex-923 in toluene at pH 6.0. The metal loaded organic phase is stripped with 2.0M HCl solution. Various parameters like effect of pH, Cyanex-923 concentration, sodium salicylate concentration, diluents, equilibration period and stripping agent on the extraction of La(III) has been studied. The stoichiometry of the extracted species of this metal ion was determined on the basis of the slope analysis method. The reaction proceed by solvation and the probable extracted species found were LaSal-HSal .2Cyanex-923.

Structural, Thermal, and Electrical Properties of PVA-Sodium Salicylate Solid Composite Polymer Electrolyte

Structural, thermal, and electrical properties of solid composite polymer electrolytes based on poly (vinyl alcohol) complexed with sodium salicylate were studied. The polymer electrolytes at different weight percent ratios were prepared by solution casting technique. The changes in the structures of the electrolytes were characterized by XRD, which revealed the amorphous domains of the polymer which increased with increase of sodium salicylate concentration. The complexion of the polymer electrolytes were confirmed by FTIR studies. Thermal gravimetric analysis (TGA) was used to study the thermal stability of the polymer below 523 K. The decomposition decreases with increasing sodium salicylate concentration. The conductivity and dielectric properties were measured using an impedance analyzer in frequency range of 20 Hz to 1 MHz and narrow temperature range of 303 to 343 K. The conductivity increased with increase of sodium salicylate concentration and temperature. The dielectric constant and dielectric loss increased with the increase in temperature and decreased with the increase in sodium salicylate concentration.

Use of fluorescence polarization immunoassay for salicylate to avoid positive/negative interference by bilirubin in the Trinder salicylate assay

Background: Significant positive bias of bilirubin in the Trinder salicylate method on automated analysers has been reported. Because the fluorescence polarization immunoassay (FPIA) for salicylate is also widely used in the clinical laboratory, we studied the potential interference of bilirubin in the salicylate FPIA. Methods: Salicylate serum pools (three different pools) were prepared from patients receiving salicylate. We also prepared a normal serum pool containing no salicylate and serum pools containing no salicylate but elevated bilirubin. Aliquots of one salicylate pool were supplemented with various concentrations of bilirubin (42.8- 427.5 µmol/L) and salicylate concentrations were measured by the salicylate FPIA (TDxFLx and AxSYM analysers). We also assayed these specimens with the Trinder salicylate method, using both Synchron LX and Hitachi 917 analysers for comparison with the results obtained by the FPIA method. In another experiment, aliquots of the two other salicylate pools were supplemented with various concentrations of bilirubin (42.8-684.0 µmol/L) in order to further study the effect of very high bilirubin concentrations on the salicylate FPIA. We also added known amounts of salicylate to serum pools containing elevated bilirubin but no salicylate and measured salicylate using the FPIA in order to study the recovery of salicylate in the presence of elevated bilirubin concentrations. Results: The FPIA showed minimal interference from bilirubin. We also observed good recovery of salicylate when specimens high in bilirubin but containing no salicylate were supplemented with known amounts of salicylate and the FPIA was used for the measurement of salicylate concentration. However, we observed falsely low salicylate concentrations with the Trinder method using the Synchron LX (primary wavelength 560 nm, secondary wavelength 700 nm) analyser and falsely increased salicylate concentrations using the same reagent but the Hitachi 917 (primary wavelength 546 nm, no secondary wavelength) analyser in the presence of elevated bilirubin levels compared with the FPIA results. Conclusion: We conclude that the FPIA for salicylate is not affected by high bilirubin concentrations up to 427.5 µmol/L.