What is the antidote for Aspirin (ASA) overdose?

In cases of Aspirin (ASA) overdose, sodium bicarbonate is used as an antidote primarily due to its ability to alkalinize the urine. This alkalinization promotes the renal excretion of salicylates (the active component in aspirin), which reduces the overall body burden of the drug. The mechanism works because aspirin is a weak acid; by increasing the pH of urine, it shifts the equilibrium to encourage the conversion of salicylic acid into its non-ionized, more soluble form, thereby facilitating its elimination through the kidneys.

The effectiveness of sodium bicarbonate is particularly important, as aspirin can cause metabolic acidosis due to its acidic nature. Alkalinizing agents like sodium bicarbonate not only help in the excretion of the drug but also can help offset some of the metabolic disturbances caused by the overdose, making it a critical treatment option in managing this condition.

The other options listed do not serve as effective antidotes for aspirin overdose and are used in different contexts in emergency medicine.