Cocaine adsorption to activated charcoal in vitro

Tomaszewski, Christian; Voorhees, Steve; Wathen, Joseph; Brent, Jeffrey; Kulig, Kenneth

doi:10.1016/0736-4679(92)90012-i

Cited by 17 publications

(6 citation statements)

References 25 publications

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“…Nevertheless, unlike cocaine, heroin has not yet been proven to be absorbed by activated charcoal (37). In addition, one heroin body packer series reports that whole bowel irrigation with polyethylene glycol may actually increase the solubility of the ingested heroin.…”

Section: Discussionmentioning

confidence: 95%

A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

Jordan

Bryant

Aks

et al. 2009

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 95%

A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

Jordan

Bryant

Aks

et al. 2009

The Journal of Emergency Medicine

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“…Patients with severe symptoms and a high risk of rupture should be monitored in the Intensive Care Unit. Activated charcoal has been used if drug leakage is suspected in cocaine poisoning, although data are limited [ 18 ]. Endoscopic retrieval should be performed by a highly trained endoscopist due to the risk of package rupture [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Intentional Foreign Body Ingestions: A Complex, Recurrent and Costly Issue

Masood

2021

Am J Case Rep

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Patient: Male, 23-year-old Final Diagnosis: Foreign body ingestion Symptoms: Abdominal pain • nausea Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • General and Internal Medicine • Psychiatry • Toxicology Objective: Rare disease Background: Recurrent intentional foreign body (RIFB) ingestion is a complex and costly issue among patients in prison and those with psychiatric disorders. Risk factors for RIFB ingestion include male sex, incarceration, and the presence of a psychiatric disorder. Most patients can be managed with observation and endoscopy. Surgery is indicated in cases involving perforation or obstruction. The literature on preventative strategies for RIFB ingestion is scarce. Case Report: A 23-year-old man required 6 admissions in 1 calendar year for intentional foreign body ingestions. The patient was living in prison and had a history of bipolar I disorder, schizophrenia, and borderline personality disorder. He underwent 9 endoscopic procedures that retrieved a total of 64 objects. The primary imaging modalities were abdominal X-ray and abdominopelvic contrast-enhanced computed tomography scan. The patient was managed with endoscopy and, in 2 cases, with observation alone. Serial abdominal examinations and abdominal films were used to monitor the progress of foreign bodies that were difficult to retrieve. A bowel regimen with polyethylene glycol facilitated the passage of the objects. The patient never required surgical intervention. The mean length of stay was 4.17 days. The recurrent ingestions may have been related to compulsions and family stress. Conclusions: Interdisciplinary collaboration is paramount in formulating effective treatment plans and limiting recurrence. Proposed strategies to prevent RIFB ingestion include the removal of ingestible objects from the environment, specialized prison units for close monitoring, early psychiatric intervention with appropriate pharmacologic/ behavioral therapy, and limiting hospital admissions to prevent secondary gain. Further studies are needed to determine the most effective approach to manage and prevent RIFB ingestion.

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“…Conservative treatment allowing the packets to pass naturally has been advocated.23 This will depend upon the clinical state and whether the packets have passed the pylorus of the stomach, failure to do so being an indication for surgical intervention.24 Activated charcoal, which actively adsorbs cocaine, is an important early adjunct to treatment. 25 In summary, management of severe cocaine poisoning is essentially supportive but early diagnosis will allow the clinician to anticipate complications and possibly prevent further release from poorly wrapped packets. A high index of suspicion for cocaine intoxication must be maintained in a comatose adult presenting with an inconsistent history, severe acidosis, seizures, or arrhythmias, especially when other common causes have been excluded.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic indicators in the early recognition of severe cocaine intoxication.

Hassan

Pickett

Durham

et al. 1996

Emergency Medicine Journal

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Acute cocaine intoxication is an ever increasing problem in the United Kingdom. Aggressive resuscitation linked to early diagnosis is essential in preventing death. Three cases of severe cocaine toxicity are presented to highlight certain diagnostic indicators in recognising the condition in patients presenting in a collapsed state to the accident and emergency departnent. Acidosis was a striking feature. The acute management of such patients is supportive and should involve methods to minimise continuing absorption.(_Accid EmergMed 1996;13:261-263)

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Cocaine adsorption to activated charcoal in vitro

Cited by 17 publications

References 25 publications

A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

Intentional Foreign Body Ingestions: A Complex, Recurrent and Costly Issue

Diagnostic indicators in the early recognition of severe cocaine intoxication.

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