Activated charcoal: Difference between revisions
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== | ==General== | ||
* | *Type: | ||
*" | *Dosage Forms: | ||
*Common Trade Names: | |||
==Adult Dosing== | |||
*25-100gm PO<ref name="AACT PP" /> | |||
*Common standard dose is 50gm | |||
==Pediatric Dosing== | |||
*0.5-1 gm/kg PO<ref name="AACT PP" /> | |||
== | ==Special Populations== | ||
* | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | ||
* | *[[Lactation risk categories|Lactation risk]]: | ||
*Renal Dosing | |||
**Adult | |||
**Pediatric | |||
*Hepatic Dosing | |||
**Adult | |||
**Pediatric | |||
== Indications == | == Indications == | ||
| Line 20: | Line 34: | ||
*They emphasize that there is no definitive data that activated charcoal improves clinical outcome | *They emphasize that there is no definitive data that activated charcoal improves clinical outcome | ||
== Contraindications == | ==Contraindications== | ||
*Altered mental status | *Altered mental status | ||
*Intestinal obstruction | *Intestinal obstruction | ||
| Line 27: | Line 41: | ||
*Instances where urgent endoscopy will be needed (eg. Ingestion of caustic material) | *Instances where urgent endoscopy will be needed (eg. Ingestion of caustic material) | ||
== | === Limitations === | ||
== | |||
*Does not work with: | *Does not work with: | ||
**Heavy metals ([[Iron Toxicity|Iron]], [[Lead Toxicity|Lead]], [[Arsenic]], [[Mercury]], Zinc) | **Heavy metals ([[Iron Toxicity|Iron]], [[Lead Toxicity|Lead]], [[Arsenic]], [[Mercury]], Zinc) | ||
| Line 43: | Line 49: | ||
**Acids/bases | **Acids/bases | ||
== | ==Adverse Reactions== | ||
*[[Aspiration Pneumonia and Pneumonitis|Aspiration]] | *[[Aspiration Pneumonia and Pneumonitis|Aspiration]] | ||
*[[Small Bowel Obstruction (SBO)|Bowel obstruction]] | *[[Small Bowel Obstruction (SBO)|Bowel obstruction]] | ||
== See Also == | ==Pharmacology== | ||
*Half-life: | |||
*Metabolism: | |||
*Excretion: | |||
===Mechanism of action=== | |||
*Large surface area of the charcoal binds toxins and prevents their absorption | |||
*Interrupts enteroenteric/enterohepatic circulation of drugs<ref name="Multi">Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. 1999;37(6):731-51.</ref> | |||
==Comments== | |||
*Created by heating wood and other natural materials in an airless environment | |||
*"Activated" by turning into fine powder, which ↑ surface area | |||
==See Also== | |||
*[[Gastric Lavage]] | *[[Gastric Lavage]] | ||
*[[Multidose Activated Charcoal (MDAC)]] | *[[Multidose Activated Charcoal (MDAC)]] | ||
== References == | ==References== | ||
<references/> | <references/> | ||
[[Category:Drugs]] | |||
[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:Tox]] | [[Category:Tox]] | ||
[[Category:EMS]] | [[Category:EMS]] | ||
Revision as of 22:49, 2 July 2015
General
- Type:
- Dosage Forms:
- Common Trade Names:
Adult Dosing
- 25-100gm PO[1]
- Common standard dose is 50gm
Pediatric Dosing
- 0.5-1 gm/kg PO[1]
Special Populations
- Pregnancy Rating:
- Lactation risk:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Indications
- Ingested drug is adsorbed by charcoal AND one of the following:
- Time since ingestion is less than 1-2hr
- Drug has significant enterohepatic circulation
- Drug delays gastric emptying AND time since ingestion is <4hr
- Drug is a controlled release preparation AND time since ingestion is <12-18hr
AACT recommendations
- Activated charcoal "should not be administered routinely in the management of poisoned patients."[1]
- Consider if patient presents within one hour of an ingestion of a toxic amount of a substance known to be absorbed by charcoal
- Administration of charcoal after an hour may continue to be beneficial
- They emphasize that there is no definitive data that activated charcoal improves clinical outcome
Contraindications
- Altered mental status
- Intestinal obstruction
- Increased risk of aspiration
- Ingestion of substances not absorbed by charcoal
- Instances where urgent endoscopy will be needed (eg. Ingestion of caustic material)
Limitations
- Does not work with:
- Heavy metals (Iron, Lead, Arsenic, Mercury, Zinc)
- Inorganic ions (Lithium, Potassium, Sodium, Flouride and Iodine)
- Hydrocarbons/essential oils
- Toxic alcohols (Ethylene Glycol, Methanol, Isopropanol)
- Acids/bases
Adverse Reactions
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
Mechanism of action
- Large surface area of the charcoal binds toxins and prevents their absorption
- Interrupts enteroenteric/enterohepatic circulation of drugs[2]
Comments
- Created by heating wood and other natural materials in an airless environment
- "Activated" by turning into fine powder, which ↑ surface area
See Also
References
- ↑ 1.0 1.1 1.2 Chyka PA, Seger D, Krenzelok EP, Vale JA; American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. Position paper: Single-dose activated charcoal. Clin Toxicol (Phila). 2005;43(2):61-87.
- ↑ Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. 1999;37(6):731-51.