Which overdose is characterized by increased anion gap acidosis and requires gastric lavage and activated charcoal?

Aspirin overdose is associated with increased anion gap metabolic acidosis due to the accumulation of organic acids resulting from the uncoupling of oxidative phosphorylation and the subsequent increased production of lactic acid. Aspirin, being a salicylate, can disrupt cellular metabolism in multiple ways, including interfering with the citric acid cycle and promoting ketogenesis, which exacerbates metabolic acidosis.

In the case of an overdose, especially with significant ingestion, patients may exhibit symptoms like tinnitus, hyperventilation (due to metabolic acidosis), and potentially altered mental status. The management for aspirin poisoning includes supportive care, including activated charcoal, which can help in adsorbing any unabsorbed drug in the gastrointestinal tract if administered within a certain timeframe. Gastric lavage may also be considered in severe cases, especially if the patient presents early after ingestion.

Other substances listed, such as acetaminophen and ibuprofen, have different mechanisms and complications associated with overdose. Acetaminophen, for instance, leads to hepatotoxicity primarily and does not typically present with anion gap acidosis, while ibuprofen usually causes gastrointestinal irritation or renal effects rather than metabolic acidosis. Cyclobenzaprine, a muscle relaxant, does not typically manifest with