Gastrointestinal ulceration or perforation may be seen after the administration of repeated doses over several days' duration. Two tablespoons of PeptoBismol contain the salicylate equivalent of one 5-grain aspirin tablet. There is no specific antidote. Multiple-dose activated charcoal is warranted. Alkalinization of the urine with sodium bicarbonate can be done to hasten urinary excretion, though this requires intense monitoring and is difficult to achieve safely.
Peritoneal dialysis allows direct removal of salicylic acid from serum.
Gastric ulceration or perforation is treated as needed. Theobromine inhibits phosphodiesterase, which results in increased cAMP and release of catecholamines. Caffeine directly stimulates the myocardium and central nervous system. It also causes a competitive antagonism of cellular adenosine receptors. Benzodiazepine receptors in the brain are competitively antagonized.