What is the mainstay of treatment in ASA overdose to facilitate the elimination of salicylates?

The mainstay of treatment in acetylsalicylic acid (ASA) overdose is urinary alkalinization. This method increases the urinary pH, which enhances the ionization of salicylate, making it less able to be reabsorbed in the renal tubules and more likely to be excreted in the urine. By shifting the pH of the urine to a more alkaline state, it facilitates the elimination of salicylate from the body, which is crucial in managing the potentially toxic effects of overdose.

While activated charcoal administration is often utilized in cases of overdose to limit further absorption of the toxin if given shortly after ingestion, it is not the primary method for enhancing elimination. Hemodialysis, on the other hand, can be indicated in more severe cases or when there is significant acidosis or fluid overload, but it is generally not the first-line treatment for ASA overdose. Fluids and electrolytes are supportive measures that address potential dehydration and electrolyte imbalances but do not directly enhance the elimination of salicylates.