Use of Activated Charcoal in Acute Poisoning

The effect of charcoal‐drug ratio on the antidotal efficacy of oral activated charcoal was studied in six healthy volunteers in a randomized cross‐over study and compared with the adsorption capacity of activated charcoal in vitro. Aminosalicylic acid (PAS) 1 g and 5 g were ingested on an empty stomach in 30 ml of water. Immediately afterwards the subjects ingested 50 g of activated charcoal in 300 ml of water or 300 ml of water only. PAS 10 g 20 g were only given with 50 g of activated charcoal administered immediately afterwards. The plasma concentrations and the cumulative excretion of PAS into urine were measured for 48 h. Increasing the dose of PAS from 1 g to 20 g reduced the antidotal efficacy of activated charcoal: at a charcoal‐drug ratio of 50:1 under 5% of the dose was absorbed but at a ratio of 2.5:1 about 37%. These data correlated well to the saturation of adsorption capacity of charcoal in vitro. To minimize the possibility of saturation of the adsorption capacity of charcoal in acute intoxications where the amount and type of drug taken is usually unknown, large doses (50‐100 g) of activated charcoal should be used.

Section: Discussionmentioning

confidence: 99%

Effect of charcoal‐drug ratio on antidotal efficacy of oral activated charcoal in man.

Olkkola¹

1985

“…Although over the years a number of techniques have been advocated to enhance elimination of quinine following overdose, including forced acid diuresis, peritoneal dialysis, haemodialysis, exchange transfusion and charcoal haemoperfusion, there is now considerable evidence to suggest that none of these techniques exert a clinically useful effect (Bateman et al, 1985). It is known that quinine is efficiently absorbed in vitro by activated charcoal (Hayden & Comstock, 1975), and theoretically, oral activated charcoal might reduce quinine absorption from the gastrointestinal tract. Of more interest, however is the observation that for some drugs oral activated charcoal can produce significant increase in the rate of elimination from plasma, even when given at a time after absorption.…”

Section: Introduction Methodsmentioning

confidence: 99%

Effect of oral activated charcoal on quinine elimination.

Lockey¹,

Bateman²

1989

The effect of repeated dose oral activated charcoal on quinine elimination has been studied following a therapeutic (600 mg) dose of quinine bisulphate to seven normal volunteers. Activated charcoal lowered quinine half‐life from 8.23 +/‐ 0.57 s.d. h to 4.55 +/‐ 0.15 s.d. h (P less than 0.001) and increased its oral clearance by 56%. Activated charcoal may have a role in the management of quinine poisoning.

“…Activated charcoal is a well known adsorbent whose ability to reduce the gastrointestinal absorption of different drugs has been shown in numerous studies as pointed out in some recent reviews (Hayden & Comstock, 1975;Neuvonen, 1982). The impairing effect of gastrointestinal contents on the adsorption capacity of activated charcoal has been known since the classical works of Andersen (1948).…”

Section: Methodsmentioning

confidence: 99%

Do gastric contents modify antidotal efficacy of oral activated charcoal?

Olkkola¹,

Neuvonen²

1984

1 The effect of food on the antidotal efficacy of activated charcoal was studied in six healthy volunteers, who ingested aspirin 1000 mg, mexiletine 200 mg and tolfenamic acid 400 mg in a randomized cross-over study. 2 Activated charcoal 25 g, suspended in water, was administered 5 min or 60 min after the drugs were taken on an empty stomach or after a standard meal. 3 The serum concentrations and the cumulative excretion into urine of the drugs were followed for 48 h. 4 When the drugs were taken on an empty stomach, activated charcoal given 5 min or 60 min afterwards reduced the bioavailability of the drugs by 75-98% or 10-60%, respectively. 5 Food moderately weakened the effect of activated charcoal administered 5 min after the drugs, but when the charcoal was given 1 h later the effect was still practically the same, the reduction of absorption varying in both cases in the range of 45-85%. Thus the efficacy of charcoal given 60 min after the drugs was better after a standard meal than on an empty stomach. 6 Presence of food in the stomach of patients with drug overdosage modifies the efficacy of activated charcoal and gives it more time to adsorb drugs in the gastrointestinal canal, possibly by slowing gastric emptying rate.