Activated charcoal: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Created | *Created by heating wood and other natural materials in an airless environment | ||
* | *"Activated" by turning into fine powder, which ↑ surface area | ||
==Mechanism of action== | ==Mechanism of action== | ||
*Large surface area of the charcoal binds toxins and prevents their absorption | *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> | |||
== Indications == | == Indications == | ||
| Line 12: | Line 13: | ||
#Drug delays gastric emptying AND time since ingestion is <4hr | #Drug delays gastric emptying AND time since ingestion is <4hr | ||
#Drug is a controlled release preparation AND time since ingestion is <12-18hr | #Drug is a controlled release preparation AND time since ingestion is <12-18hr | ||
===AACT recommendations=== | ===AACT recommendations=== | ||
*Does '''''NOT''''' recommend routine charcoal administration to all overdose patients | *Does '''''NOT''''' recommend routine charcoal administration to all overdose patients | ||
| Line 19: | Line 21: | ||
== Contraindications == | == Contraindications == | ||
* | *Altered mental status | ||
*Intestinal obstruction | *Intestinal obstruction | ||
*Increased risk of aspiration (eg. Hydrocarbon ingestion) | *Increased risk of aspiration (eg. Hydrocarbon ingestion) | ||
Revision as of 03:45, 2 July 2015
Background
- Created by heating wood and other natural materials in an airless environment
- "Activated" by turning into fine powder, which ↑ surface area
Mechanism of action
- Large surface area of the charcoal binds toxins and prevents their absorption
- Interrupts enteroenteric/enterohepatic circulation of drugs[1]
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
- Does NOT recommend routine charcoal administration to all overdose patients
- 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 (eg. Hydrocarbon ingestion)
- 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
Dose
- 1gm/kg PO (min 50gm)
- Mix with water or juice
- It is NOT necessary for charcoal to be administered by a NGT or OGT
- Improved taste if activated charcoal is chilled
- In children, may mix with juice, yogurt or ice-cream
Complications
See Also
References
- ↑ 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.
- Haddad and Winchester's Clinical Management of Poisoning and Overdose
- Uptodate