Acidosis, hypoxia, and generalized CNS depression predispose to the development of cardiac arrhythmias. Respiratory acidosis quickly subsides as ventilation is restored and hypercapnea is eliminated, however, lactic acidosis may require i.v. bicarbonate for prompt correction. Electrocardiographic monitoring is essential. Oxygen, i.v. fluids, vasopressors, and other supportive measures should be employed as indicated. Analeptic agents should not be used, since CNS stimulants may precipitate fatal convulsions.
Dialysis is of little value in poisoning by propoxyphene alone.
Efforts should be made to determine whether other CNS depressants were taken concomitantly, since these increase CNS depression and cause other specific toxic effects. Treatment of acute salicylate intoxication includes minimizing drug absorption, promoting elimination through the kidneys, and correcting metabolic derangements. If the patient is seen within 4 hours, the stomach should be emptied, when possible, by inducing emesis or by gastric lavage. Intermittent peritoneal dialysis is useful for adult cases of moderate severity. Hemodialysis with an artificial kidney is the most effective means of removing salicylate and is indicated for very severe cases.