In Vitro Adsorption of Acetaminophen onto Activated Charcoal

Bainbridge, Carol A.; Kelly, Ernest L.; Walkling, W. Douglas

doi:10.1002/jps.2600660405

Cited by 44 publications

(24 citation statements)

References 6 publications

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“…It is recommended that the amount of charcoal given should be 10 times the amount of drug ingested but in practice giving more than lOOgms of charcoal increases the risk of vomiting, as occurred in three of the seven patients in this trial who swallowed 100 gms or more. The optimum ratio, however, is not known and in vitro the maximum absorptive capacity is about 250mg paracetamol per gram of activated charcoal (Bainbridge et al, 1977). The absorptive capacity of charcoal is less in vivo and a charcoal to paracetamol ratio of 5 to 1 will reduce absorption by about 60% (Dordoni et al, 1973).…”

Section: Discussionmentioning

confidence: 99%

A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose.

Underhill

Greene

Dove

1990

Emergency Medicine Journal

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SUMMARYThe aim of this prospective trial was to compare the efficacy of gastric lavage, activated charcoal and ipecacuanha at limiting the absorption of paracetamol in overdose and to assess the significance of the continued absorption of paracetamol following treatment. Patients aged 16 and over who had ingested 5 gms or more of paracetamol within 4 h of admission were entered into the trial. The percentage fall in plasma paracetamol level was used as the measure of the success of a treatment at limiting absorption. The mean percentage fall was 39-3 for gastric lavage, 52-2 for activated charcoal and 40.7 for ipecacuanha, with a significant difference between the treatment methods (p = 0.03). Activated charcoal was more effective at limiting the absorption of paracetamol following overdose than either gastric lavage or ipecacuanha induced emesis. In treated patients continuing paracetamol absorption is not significant if more than 2 h have elapsed since ingestion.

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Section: Discussionmentioning

confidence: 99%

A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose.

Underhill

Greene

Dove

1990

Emergency Medicine Journal

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“…The desorption of paracetamol (at pH 1.2) with a single elution was 0.4% at a charcoal-paracetamol ratio of 8:1, but 26.5% when the ratio was 0.8:1 (Bainbridge et al, 1977).…”

Section: Reversibility Of Adsorptionmentioning

confidence: 98%

“…is practically unchanged in the pH range of the gastrointestinal tract (Bainbridge et al, 1977;Boehm and Oppenheim, 1977) while that of tricyclic antidepressants and phenylpropanolamine increases with the pH (Boehm and Oppenheim, 1977;Sellers et al, 1977;Tsuchiya and Levy, 1 972b).…”

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confidence: 95%

Clinical Pharmacokinetics of Oral Activated Charcoal in Acute Intoxications

Neuvonen

1982

Clinical Pharmacokinetics

152

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Activated charcoal has the ability to adsorb a wide variety of substances onto its sUrface. This property can be applied in preventing the absorption of various drugs and toxins from the gastrointestinal tract and in some cases to increase their rate of elimination. In vitro. the extent of adsorption depends mainly on the relative amounts oj the charcoal and the drug ingested. but the quality and formulation of the activated charcoal. as well as other Jactors such as the pH of the incubation medium also have an effect. Under optimum conditions the adsorption to charcoal is a rapid process but desorption from charcoal is possible due. for example. to competition by other substances or to changes in pH.In acute poisonings the most important determinants of the efficacy oj activated charcoal are the delay in the administration and the amount of activated charcoal given. Activated charcoal should be given as a water suspension as soon as possible. preferably within 30 minutes oJthe ingestion of the toxic agent. However. in acute intoxications the absorption of drugs may be considerably delayed and thus charcoal may be effective when administered 24 hours after drug ingestion. At a constant charcoal-drug ratio. the adsorption capacity oj charcoal increases with increasing doses because the competitive effect of gastrointestinal contents diminishes. Thus the amount oj charcoal should be as high as feasible. i.e. about 50 to lOOg in adults. This amount is able to adsorb lethal doses of many drugs. Significant desorption from charcoal and subsequent systemic absorption of a drug is possible if inadequate amounts of charcoal are used. The adsorption to charcoal is more complete in poisonings with potent drugs. i.e. where the charcoal-drug ratio is high (e.g. digitalis glycosides. tricyclic antidepressants. etc.). With some drugs the adsorption capacity may be exceeded, e.g. in aspirin poisonings, but even in these cases the charcoal may adsorb that fraction oj the drug which is dissolved in the gastrointestinal./luids.In experimental studies. the efficacy of charcoal in preventing systemic absorption oj many drugs has been of the same order or even better than that of emesis, but in certain poisonings the efficacy oj charcoal is inadequate, e.g. in those caused by ethanol, methanol or iron salts. Charcoal is rather ineffective and may even be contraindicated in poisonings caused by caustic alkalis or acids. Charcoal is non-toxic but, if administered too rapidly, patients may vomit.Some drugs and toxic agents have a long elimination half-life and are excreted into the gastrointestinal tract and then reabsorbed. With such agents multiple oral doses of activated charcoal, e.g. 20g every 6 hours Jor 1 or 2 days, can accelerate their elimination and shorten the duration of intoxication.

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“…MC exhibits good adsorption potential to AA, and is possibly useful for detoxi-cation induced by AA overdose. [20][21][22] Thus, in the present study, AA was chosen as a model adsorption drug to MC.…”

Section: Introductionmentioning

confidence: 99%

“…20,23) MC has the characteristics of high scattering and adhesion to the used container. Also, as the patients must generally ingest a large amount of MC, they are forced to drink a lot of water or an aqueous suspension, resulting in reduced compliance.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Evaluation of Medicinal Carbon Granules by Wet Granulation Method Using Carboxymethylcellulose Sodium as a Binding Agent

Miyachi¹,

Onishi

2013

Jpn. J. Pharm. Health Care Sci.

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Medicinal carbon (MC) granules were prepared by the wet granulation method (wet mass extrusion) using carboxymethylcellulose sodium (CMC-Na) as a binding agent. In addition, croscarmellose sodium (CC-Na) was used as an additive at 0 -10％ (w/w) to MC. The obtained granules were examined in vitro for the physical strength, disintegration properties and adsorption characteristics. From friability tests, all the granules had good strength. They slightly disintegrated in the disintegration test with water for 30 min, but the addition of CC-Na significantly reduced the granule weight after the disintegration test. It was suggested that the addition of CC-Na should facilitate water immersion and consequently cause components such as CMC-Na or CC-Na to be lost partially; though such changes in the physical state could not be discernible to the naked eye. In adsorption experiments using acetaminophen solution (0.6 mg/mL), the adsorption capacity was almost retained in all the granules. Although the adsorption rate of the granules without CC-Na was fairly slower than that of MC powder, it was significantly improved by the addition of the CC-Na at 4 and 10％ (w/w). In particular, the granules with CC-Na at 10％ (w/w) displayed 65％ (w/w) of saturated adsorption with a small coefficient of variance (<7％) at 20 min after the start of the adsorption test. Thus, since the MC granules with CC-Na at 10％ displayed good physical strength, high adsorption capacity and a fairly fast adsorption rate, they are suggested to be useful as a compact MC dosage form.

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In Vitro Adsorption of Acetaminophen onto Activated Charcoal

Cited by 44 publications

References 6 publications

A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose.

A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose.

Clinical Pharmacokinetics of Oral Activated Charcoal in Acute Intoxications

In Vitro Evaluation of Medicinal Carbon Granules by Wet Granulation Method Using Carboxymethylcellulose Sodium as a Binding Agent

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