In cases of aspirin overdose, what is the primary treatment method?

In cases of aspirin overdose, sodium bicarbonate is the primary treatment method due to its ability to alkalinize the urine, which enhances the renal excretion of salicylate (the active metabolite of aspirin). By increasing the urine pH, sodium bicarbonate promotes the ionization of salicylate, reducing its reabsorption in the renal tubules, and thereby facilitating its elimination from the body.

This treatment is particularly effective because salicylate levels can rise significantly in overdose situations, leading to serious metabolic acidosis and respiratory issues. Alkalinization not only aids in the clearance of the drug but also can help correct the metabolic acidosis that can develop during an overdose.

Other treatments have specific uses but do not directly address the primary mechanism of aspirin toxicity. For instance, while N-acetylcysteine is an antidote for acetaminophen (Tylenol) overdose and calcium chloride and glucagon have their roles in other medical scenarios, they are not indicated in the management of aspirin overdose. Thus, sodium bicarbonate stands out as the first-line treatment in cases of aspirin toxicity.