Activated charcoal: Difference between revisions
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*Created from carbonaceous materials | *Created from carbonaceous materials | ||
**Pryolysis (heating to 600-900 degrees C in the absence of oxygen | **Pryolysis (heating to 600-900 degrees C in the absence of oxygen | ||
==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 | ||
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== Dose == | == Dose == | ||
#1gm/kg PO | #1gm/kg PO (min 50gm) | ||
#Mix with water or juice | #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 == | == Complications == | ||
Revision as of 03:21, 2 July 2015
Background
- Created from carbonaceous materials
- Pryolysis (heating to 600-900 degrees C in the absence of oxygen
Mechanism of action
- Large surface area of the charcoal binds toxins and prevents their absorption
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
- Depressed 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
- Haddad and Winchester's Clinical Management of Poisoning and Overdose
- Uptodate