Sodium excretion produced by spironolactone may be decreased in the presence of salicylates. Salicylates also retard the renal elimination of methotrexate. Caffeine may cause nausea, nervousness, insomnia, headache, vomiting, palpitation, vertigo, muscle tremor, sensory disturbances, excessive diuresis in sensitive patients. Large doses may cause gastric ulceration. Severe cases may show fever, hemorrhage, excitement, confusion, convulsions or coma, and respiratory failure.
Treatment is essentially symptomatic and supportive.
Administer water, universal antidote and remove by gastric lavage or emesis. If the patient is unable to retain fluids orally, the alkalosis can be treated by hypertonic saline i.v. Vitamin K is indicated if there is evidence of hemorrhage. Hemodialysis has been used with success. General supportive measures for depressed respiration e.g., oxygen and artificial respiration.