Initially there is a respiratory alkalosis due to a direct stimulatory effect on the respiratory centre. To compensate for this there is a loss of bicarbonate from the urine with loss of sodium, potassium and water. This eventually results in a metabolic acidosis, with hypokalaemia and dehydration.
Salicylate also inhibits kreb's cycle causing further acidosis due to increasing levels of lactate and pyruvate. There are changes in fat and protein metabolism resulting in ketone body formation and amino-acidaemia/uria.
Other features of salicylate poisoning also include pulmonary oedema, cerebral oedema, renal failure, tinnitus.
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