Activated Charcoal in the Treatment of Drug Overdose

The main characteristic of overdose with controlled release formulations is the delay in presentation and onset of clinical effects. There is a prolonged absorption phase which leads to a delayed time to maximum plasma concentration and usually a prolonged time with levels close to the peak concentration. Absorption may continue for more than 24 hours. Overdose with controlled release formulations of toxic drugs therefore requires a longer period of observation as the onset of symptoms may be as late as 16 to 20 hours after ingestion. Treatment nomograms calculated for standard formulations are not appropriate for controlled release formulations. The optimal gastrointestinal decontamination method is controversial, but in serious overdoses it should include gastric lavage and activated charcoal followed by whole bowel irrigation as a means of clearing whole tablets from the gastrointestinal tract. Pharmacobezoar formation should be suspected if, despite apparently effective gastrointestinal decontamination, there is evidence of continuing absorption. These are best diagnosed with endoscopy and the treatment options include endoscopic removal, whole bowel irrigation and surgery.

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“…[65,661 Its exact place in the treatment of poisonings caused by controlled release preparations is still being defined.…”

Section: Activated Charcoalmentioning

confidence: 99%

Controlled Release Drugs in Overdose Clinical Considerations

1995

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“…As a matter of fact, Winnipeg's Wesley Palatnick and Milton Tenenbein -without doubt Dr Tenenbein has been one of the most productive and creative investigators in this field -have recently summarised the evidence available to support the use of activated charcoal (Palatnick & Tenenbein 1992). They conclude that adding sorbitol to charcoal confers no additional benefit (of course, there is clearly some benefit in terms of patient acceptability!)…”

mentioning

confidence: 99%

Syrup of Ipecac in 1993

Haulman

Robertson

1993

Drug Safety

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Toxicology and Management of Acute Drug Ingestions in Adults

Herrington,

Clifton

1995

Pharmacotherapy

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We reviewed the current literature on the toxicology and management of acute drug ingestions in adults after a MEDLINE search of English‐language journal articles. Information on toxicology was also acquired from relevant textbooks. Present statistics were gathered through information from the U.S. Department of Health and Human Services and the American Association of Poison Control Centers. All patients with acute drug ingestions should be treated with supportive care initially, and when stabilized, undergo active removal of the ingested substance, based on the diagnostic and prognostic assessment. Identification of the ingested substance may prove useful in some instances when specific therapy or antidotes are indicated.

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Activated Charcoal in the Treatment of Drug Overdose

Cited by 23 publications

References 48 publications

Controlled Release Drugs in Overdose Clinical Considerations

Controlled Release Drugs in Overdose Clinical Considerations

Syrup of Ipecac in 1993

Toxicology and Management of Acute Drug Ingestions in Adults

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