What is the treatment for NSAID toxicity?

The correct treatment for NSAID toxicity is IV sodium bicarbonate. The rationale behind this choice lies in the metabolic effects of NSAID overdose, which can lead to metabolic acidosis. Sodium bicarbonate serves to correct this acidosis by increasing the bicarbonate concentration in the plasma, therefore helping to shift the acid-base balance back towards normal.

Additionally, in severe cases, sodium bicarbonate can also help to alkalinize the urine, which can enhance the renal excretion of certain acidic drugs and metabolites. This is particularly beneficial when dealing with substances that can cause significant toxicity, as it can assist in preventing further complications.

While activated charcoal may be a useful treatment for certain types of poisoning by adsorbing drugs in the gastrointestinal tract, it is not specific to NSAID toxicity and is typically used when ingestion has occurred within a certain time frame. IV fluids can definitely be supportive in managing symptoms resulting from NSAID toxicity, especially if there is renal impairment or dehydration. However, they do not address the underlying metabolic disturbance like sodium bicarbonate does. IV calcium gluconate is generally reserved for conditions like hypocalcemia or certain types of cardiac toxicity, thus not relevant in NSAID overdose treatment.