Multidose activated charcoal: Difference between revisions
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*No evidence to suggest that MDAC decreases morbidity or mortality | *No evidence to suggest that MDAC decreases morbidity or mortality | ||
**Some evidence shows that MDAC increases the elimination of certain drugs (further explained below) | **Some evidence shows that MDAC increases the elimination of certain drugs (further explained below) | ||
*Functions to prevents the absorption of xenobiotics that are slowly absorbed and to enhance the elimination of certain xenobiotics that have already been absorbed | |||
**large amounts of xenobiotics ingested or dissolution is delayed (masses, bezoars) | |||
**formulations that exhibit a delayed or prolonged release phase (enteric coated, extended release) | |||
**GI motility is impaired | |||
**prevent reabsoprtion (enterohepatic circulation of active xenobiotic or metabolite) | |||
==Dosing== | ==Dosing== | ||
*12.5 g/hr in divided doses (eg. 50g Q4hr) | *12.5 g/hr in divided doses (eg. 50g Q4hr) | ||
*Should avoid sorbitol-containing formulation in MDAC therapy, as may lead to electrolyte disturbance secondary to diarrhea | |||
==Contraindications== | ==Contraindications== | ||
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**Carbamazepine | **Carbamazepine | ||
**Quinine | **Quinine | ||
*There is also some evidence of utility of MDAC in salicylate overdose | |||
==Mechanism of Action== | ==Mechanism of Action== | ||
Latest revision as of 18:02, 26 March 2018
Background
- Method of enhanced elimination that uses multiple doses of activated charcoal
- No evidence to suggest that MDAC decreases morbidity or mortality
- Some evidence shows that MDAC increases the elimination of certain drugs (further explained below)
- Functions to prevents the absorption of xenobiotics that are slowly absorbed and to enhance the elimination of certain xenobiotics that have already been absorbed
- large amounts of xenobiotics ingested or dissolution is delayed (masses, bezoars)
- formulations that exhibit a delayed or prolonged release phase (enteric coated, extended release)
- GI motility is impaired
- prevent reabsoprtion (enterohepatic circulation of active xenobiotic or metabolite)
Dosing
- 12.5 g/hr in divided doses (eg. 50g Q4hr)
- Should avoid sorbitol-containing formulation in MDAC therapy, as may lead to electrolyte disturbance secondary to diarrhea
Contraindications
- Same as with Single Dose Activated Charcoal (SDAC)
- Intestinal obstruction (absolute)
- Decreased gut motility (relative)
Indications
- Mnemonic: These People Drink Charcoal Quickly
- Theophylline
- Phenobarbital
- Dapsone
- Carbamazepine
- Quinine
- There is also some evidence of utility of MDAC in salicylate overdose
Mechanism of Action
- Stops enterohepatic circulation
- Increases passive diffusion and acts as a sink for the xenobiotics
- Binds drugs in extended release formulations