Activated charcoal: Difference between revisions
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*Type: Antidote | *Type: Antidote | ||
*Dosage Forms: | *Dosage Forms: | ||
*Common Trade Names: | *Common Trade Names: Actidose-Aqua [OTC]; Actidose/Sorbitol [OTC]; Char-Flo with Sorbitol [OTC]; EZ Char [OTC]; Kerr Insta-Char in Sorbitol [OTC]; Kerr Insta-Char [OTC] | ||
==Adult Dosing== | ==Adult Dosing== | ||
Revision as of 19:40, 30 December 2015
General
- Type: Antidote
- Dosage Forms:
- Common Trade Names: Actidose-Aqua [OTC]; Actidose/Sorbitol [OTC]; Char-Flo with Sorbitol [OTC]; EZ Char [OTC]; Kerr Insta-Char in Sorbitol [OTC]; Kerr Insta-Char [OTC]
Adult Dosing
- 25-100gm PO[1]
- Common standard dose is 50gm
Pediatric Dosing
- 0.5-1 gm/kg PO[1]
Special Populations
- Pregnancy Rating: not absorbed
- Lactation risk: not absorbed
- Renal Dosing none
- Adult
- Pediatric
- Hepatic Dosing none
- 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: not absorbed
- Metabolism: not absorbed
- Excretion: excreted whole in feces
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.