Activated charcoal is the single most widely used method of gastrointestinal (GI) decontamination for the treatment of the poisoned patient. Generically, decontamination refers to efforts to inhibit absorption of drugs and poisons after exposure. Annual American Association of Poison Control Centers data documents use patterns for each of the 4 general methods of GI decontamination in cases reported to America’s 62 poison control centers.
Data for 2004 reveal that, of 2,438,644 human exposures, 130,938 patients were given single dose
coconut shell activated charcoal (5.4% of patients), gastric lavage was performed in 16,179 patients (0.66%), 4,701 received syrup of ipecac (0.19%) and 2,961 (0.12%) underwent whole bowel irrigation.
Activated charcoal is prepared by pyrolysis of wood or other carbonaceous material, and then oxidation of the pyrolyzed product with steam or carbon dioxide. The fine particles which result have a surface area of 1,000 – 2,000 m2 per gram. The surface of activated charcoal contains several moieties that adsorb drugs and poisons to varying degrees.
Activated charcoal is available in many preparations for many uses. It is used in California to purify drinking water contaminated with substances such as 1,2-dibromo-3-chloropropane (DBCP). Charcoal prepared for medicinal use must meet USP standards for adsorptive capacity, purity, and microbial contamination.
While pharmaceutical activated charcoal is available as a suspension in either water or sorbitol, the plain aqueous preparation is usually preferred. If sorbitol is used, only one dose is given, as repeated use of the cathartic has caused serious fluid and electrolyte disturbances, and often provokes abdominal cramping. Activated charcoal in either water or sorbitol is usually sold as 50 grams charcoal in 240 ml total volume.
In some cases, the rate of elimination of a drug that has already been absorbed can be accelerated by giving Multiple Dose of Activated Charcoal (MDAC). Drugs that are removed by this method either undergo extensive entero-hepatic reabsorption or are drugs that have an unusual affinity for charcoal, and can be attracted across the capillary-gut interface for adsorption.
https://www.coalactivatedcarbon.com This is referred to as “gastrointestinal dialysis.” Examples of such agents where MDAC may be of benefit are theophylline and carbamazepine, and ingestions of cardiac glycoside containing plants.
Activated charcoal is the single most widely used method of gastrointestinal (GI) decontamination for the treatment of the poisoned patient. Generically, decontamination refers to efforts to inhibit absorption of drugs and poisons after exposure. Annual American Association of Poison Control Centers data documents use patterns for each of the 4 general methods of GI decontamination in cases reported to America’s 62 poison control centers.
