Saline Catharsis: Effect on Aspirin Bioavailability in Combination with Activated Charcoal

Sketris, Ingrid; Mowry, James B.; Czajka, Peter A.; Anderson, William H.; Stafford, David T.

doi:10.1002/j.1552-4604.1982.tb05709.x

Cited by 42 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In experimental animals there is some but not unambiguous evidence that purgatives would increase the antidotal efficacy of oral activated charcoal (Laass, 1980;Chin et al, 1981;Picchioni et al, 1982;Van de Graaff et al, 1982;Gaudreault et al, 1985). Human studies have failed to show any substantial beneficial effects of purgatives in combination with charcoal (Mayersohn et al , 1977;Easom et al , 1982;Sketris et al , 1982; Galinsky & Levy, 1984).…”

Section: Discussionmentioning

confidence: 92%

“…In experimental animals purgatives have either improved (Laass, 1980;Chin et al , 1981;Picchioni et al , 1982;Gaudreault et al , 1985) or diminished (Van de Graaff et al, 1982) the antidotal efficacy of charcoal. Studies in man have failed to demonstrate any substantial benefit from the combined use of purgatives and charcoal (Mayersohn et al 1977;Easom et al , 1982;Sketris et al, 1982;Galinsky & Levy, 1984). However, there seems to be no information concerning the effects of other than saline and osmotic purgatives on the antidotal efficacy of charcoal in man.…”

Section: Introductionmentioning

confidence: 91%

See 1 more Smart Citation

Effect of Purgatives on Antidotal Efficacy of Oral Activated Charcoal

Neuvonen

Olkkola

1986

Human Toxicology

View full text Add to dashboard Cite

1 The effects of purgatives on the antidotal efficacy of oral activated charcoal were studied in seven volunteer subjects. 2 The volunteer subjects were given 1000 mg of aspirin, 100 mg of atenolol and 50 mg of phenylpropanolamine with 100 ml of water on an empty stomach and were assigned randomly to the following treatment groups: (A) after 5 min 150 ml of water, (B) after 5 min 25 g of charcoal, (C) after 5 min charcoal orally with 20 mg of metoclopramide rectally, followed by 10 mg of bisacodyl rectally 3 h afterwards, (D) after 5 min charcoal with 250 ml of magnesium citrate USP and (E) after 60 min charcoal with metoclopramide followed by bisacodyl 3 h thereafter. 3 The plasma concentrations (0-24 h) and the cumulative urinary excretion (0-72 h) of salicylates, atenolol and phenylpropanolamine were measured. 4 Both magnesium citrate and metoclopramide combined with bisacodyl hastened the gastrointestinal transit but magnesium citrate was more effective. 5 Charcoal alone reduced the absorption of aspirin and phenylpropanolamine by about 50% and that of atenolol by about 95%. The purgatives did not modify significantly the efficacy of charcoal. 6 When the antidotal treatment was delayed by 60 min its efficacy was reduced to some extent, possibly depending on the pharmaceutical formulation of the test drugs. 7 The present results do not support the routine use of purgatives in combination with activated charcoal. In some instances, however, their use may promote the evacuation of, for example, depot formulations from the gastrointestinal tract and thus have a beneficial effect together with activated charcoal in reducing absorption.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 91%

Effect of Purgatives on Antidotal Efficacy of Oral Activated Charcoal

Neuvonen

Olkkola

1986

Human Toxicology

View full text Add to dashboard Cite

show abstract

“…There is no evidence that single-dose charcoal has a constipating effect, with the mean time to first stool being 23.5h (Krenzelok et al 1985). Minimising the effects of desorption by decreasing gastrointestinal transit time is an attractive hypothesis, but 5 human studies did not show decreased drug absorption when carthartics were added to charcoal (Easom et al 1982;Mayersohn et al 1977;McNamara et al 1988;Neuvonen & Olkkola 1986;Sketris et al 1982). A modest treatment effect of a 14.2% decrease in salicylate absorption when sorbitol was added to charcoal was demonstrated by Keller et al (1990), which is of questionable clinical significance.…”

Section: Concomitant Cathartic Therapymentioning

confidence: 93%

Activated Charcoal in the Treatment of Drug Overdose

Palatnick

Tenenbein

1992

Drug Safety

View full text Add to dashboard Cite

“…Activated charcoal, single-dose There were 13 clinical trials (level 1b) that examined the effect of activated charcoal on aspirin absorption (193)(194)(195)(196)(197)(198)(199)(200)(201)(202)(203)(204)(205). None of these studies was performed as out-of-hospital care.…”

Section: Treatment Measuresmentioning

confidence: 99%

“…One study showed it to be more efficacious than ipecac syrup (195), but another study found that both treatments were equally efficacious (196). The addition of magnesium citrate to activated charcoal had little effect on the efficacy of charcoal in two studies (198,205). The addition of sorbitol improved the efficacy of activated charcoal in one study (200), but reduced it in another (202).…”

Section: Treatment Measuresmentioning

confidence: 99%

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

Chyka

Erdman

Christianson

et al. 2007

Clinical Toxicology

115

View full text Add to dashboard Cite

American Association of Poison Control Centers, Washington, District of Columbia, USAA review of U.S. poison center data for 2004 showed over 40,000 exposures to salicylate-containing products. A guideline that determines the conditions for emergency department referral and pre-hospital care could potentially optimize patient outcome, avoid unnecessary emergency department visits, reduce health care costs, and reduce life disruption for patients and caregivers. An evidence-based expert consensus process was used to create the guideline. Relevant articles were abstracted by a trained physician researcher. The first draft of the guideline was created by the lead author. The entire panel discussed and refined the guideline before distribution to secondary reviewers for comment. The panel then made changes based on the secondary review comments. The objective of this guideline is to assist poison center personnel in the appropriate out-of-hospital triage and initial out-of-hospital management of patients with a suspected exposure to salicylates by 1) describing the process by which a specialist in poison information should evaluate an exposure to salicylates, 2) identifying the key decision elements in managing cases of salicylate exposure, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline is based on an assessment of current scientific and clinical information. The expert consensus panel recognizes that specific patient care decisions may be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all of the circumstances involved. This guideline does not substitute for clinical judgment. Recommendations are in chronological order of likely clinical use. The grade of recommendation is in parentheses: 1) Patients with stated or suspected self-harm or who are the victims of a potentially malicious administration of a salicylate, should be referred to an emergency department immediately. This referral should be guided by local poison center procedures. In general, this should occur regardless of the dose reported (Grade D).2) The presence of typical symptoms of salicylate toxicity such as hematemesis, tachypnea, hyperpnea, dyspnea, tinnitus, deafness, lethargy, seizures, unexplained lethargy, or confusion warrants referral to an emergency department for evaluation (Grade C). 3) Patients who exhibit typical symptoms of salicylate toxicity or nonspecific symptoms such as unexplained lethargy, confusion, or dyspnea, which could indicate the development of chronic salicylate toxicity, should be referred to an emergency department (Grade C). 4) Patients without evidence of self-harm should have further evaluation, including determination of the dose, time of ingestion, presence of symptoms, history of other medical conditions, and the presence of co-ingestants. The acute ingestion of more than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less, war...

show abstract

Saline Catharsis: Effect on Aspirin Bioavailability in Combination with Activated Charcoal

Cited by 42 publications

References 14 publications

Effect of Purgatives on Antidotal Efficacy of Oral Activated Charcoal

Effect of Purgatives on Antidotal Efficacy of Oral Activated Charcoal

Activated Charcoal in the Treatment of Drug Overdose

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

Contact Info

Product

Resources

About