Effect of oral activated charcoal on quinine elimination.

Lockey, David; Bateman, D. N.

doi:10.1111/j.1365-2125.1989.tb05340.x

Cited by 35 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has been demonstrated both in volunteers following a therapeutic dose of quinine bisulphate (Lockey & Bateman, 1989) and in patients following overdose where the mean half-life was 8.1 h compared with 24 h in a similar group of poisoned patients not given activated charcoal (Bateman et al, 1985b;Prescott et al, 1989). In one patient despite a 36-h delay between overdose and starting oral activated charcoal the half-life was reduced from 33h to 10h (Prescott et al, 1985).…”

Section: Discussionmentioning

confidence: 93%

The management of quinine-induced blindness.

Guly

Driscoll²

1992

Emergency Medicine Journal

View full text Add to dashboard Cite

Quinine is rarely taken in overdose (Pearn et al., 1984;Boland et al., 1985). We present a case where blindness resulted from an accidental overdose of only eight tablets of quinine sulphate. Opinion regarding both the aetiology and the management of quinine-induced blindness has altered in recent years (Boland et al., 1984;Dyson et al., 1985;Dyson et al., 1986). This case suggests that expert advice received regarding this condition may not be that recommended in the light of these changes.Case report A 40-year-old man presented to the A&E Department at Hope Hospital at 9 a.m. having become blind overnight. At 8 p.m. the previous day he had developed a mild frontal headache and had taken two of his father's tablets which he believed to be painkillers. His headache did not improve and over the next 8 h he took a further six tablets. During the night he noticed that the street lights became dim and disappeared. When he woke in the morning he was blind and had a buzzing noise in his ears.On examination both pupils were fixed and dilated and there was no light perception in either eye. Fundoscopy was normal. He appeared to have slight hearing impairment but examination was otherwise normal.He brought with him the bottle of tablets he had taken. This contained quinine sulphate tablets which had been prescribed for his father for muscle cramps.Gastric lavage was carried out and repeated doses of activated charcoal were given. The Poisons Information Centre recommended unilateral stellate ganglion block (SGB) after being seen by an opthalmologist. On the advice of the duty ophthalmologist bilateral SGBs were performed at 5.30 p.m.

show abstract

Section: Discussionmentioning

confidence: 93%

The management of quinine-induced blindness.

Guly

Driscoll²

1992

Emergency Medicine Journal

View full text Add to dashboard Cite

show abstract

“…Although advocated in the past, urinary acidification has not been shown to reduce the elimination half‐life of quinine in poisoned patients and does not greatly enhance quinine removal 17 . Although extracorporeal methods of elimination have been previously used, they are ineffective at enhancing removal of quinine and are not recommended 17,27,28 .…”

Section: Discussionmentioning

confidence: 99%

Quinine toxicity

Pearson

1998

Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…• Studies in volunteers have demonstrated that multiple-dose activated charcoal increases the elimination of carbamazepine, 5 dapsone, 6 dextropropoxyphene, 7 digitoxin, 8,9 digoxin, 8-10 disopyramide, 11 nadolol, 12 phenobarbital, 5,13-15 phenylbutazone, 5 phenytoin, 16,17 piroxicam, 18 quinine, 19 sotalol, 20 and theophylline. [21][22][23][24][25][26] • The elimination of salicylate was increased by multiple-dose activated charcoal in two studies, 27,28 but not in two other studies.…”

Section: Volunteer Studiesmentioning

confidence: 99%

“…19 Activated charcoal 50 g was administered 4 hours after quinine dosing and 3 further doses were given over the next 12 hours. The effect of multiple-dose activated charcoal on quinine elimination was studied following a therapeutic (600 mg) dose of quinine bisulphate to 7 adult fasted volunteers.…”

Section: Reprintsmentioning

confidence: 99%

Position Statement and Practice Guidelines on the Use of Multi-Dose Activated Charcoal in the Treatment of Acute Poisoning

Toxicologists¹

1999

Journal of Toxicology: Clinical Toxicology

296

View full text Add to dashboard Cite

In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. 1-124 Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not usually considered. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. The Position Statement went through multiple drafts before being approved by the Boards of the two societies.The Position Statement includes a summary statement for ease of use and is supported by detailed documentation which describes the scientific evidence on which the Statement is based. Although many studies in animals and volunteers have demonstrated that multiple-dose activated charcoal increases drug elimination significantly, this therapyhas not yet been shown in a controlled study in poisoned patients to reduce morbidity and mortality. Further studies are required to establish its role and the optimal dosage regimen of charcoal to be administered. Based on experimental and clinical studies, multiple-dose activated charcoal should be considered only if a patient has ingested a life-threatening amount of carbamazepine, dapsone, phenobarbital, quinine, or theophylline. With all This Position Statement is endorsed by the Canadian Association of Poison Control Centres. 731 Clinical Toxicology Downloaded from informahealthcare.com by Nyu Medical Center on 07/28/15For personal use only. ORDER REPRINTS 732AACT and EAPCCT of these drugs there are data to confirm enhanced elimination, though no controlled studies have demonstrated clinical benefit.Although volunteer studies have demonstrated that multiple-dose activated charcoal increases the elimination of amitriptyline, dextropropoxyphene, digitoxin, digoxin, disopyramide, nadolol, phenylbutazone, phenytoin, piroxicam, and sotalol, there are insufficient clinical data to support or exclude the use of this therapy.The use of multiple-dose charcoal in salicylate poisoning is controversial. One animal study and 2 of 4 volunteer studies did not demonstrate increased salicylate clearance with multiple-dose charcoal therapy. Data in poisoned patients are insufficient presently to recommend the use of multiple-dose charcoal therapy for salicylate poisoning.Multiple-dose activated charcoal did not increase the elimination of astemizole, chlorpropamide, doxepin, imipramine, meprobamate, methotrexate, phenytoin, sodium valproate, tobramycin, and vancomycin in experimental and/or clinical studies.Unless a patient has an intact or protected airway, the administration of multiple-dose activated charcoal is contraindicated. It should not be used in the presence of an intestinal obstruction. The need for concurrent administration of cathartics remains unproven and is not recommended. In particular, cathartics shoul...

show abstract

Effect of oral activated charcoal on quinine elimination.

Cited by 35 publications

References 6 publications

The management of quinine-induced blindness.

The management of quinine-induced blindness.

Quinine toxicity

Position Statement and Practice Guidelines on the Use of Multi-Dose Activated Charcoal in the Treatment of Acute Poisoning

Contact Info

Product

Resources

About