Activated charcoal

• Used to decrease the GI absorption of oral toxins
• Activated charcoal doesn’t get absorbed through the gastric wall, and is passed without any changes
• Toxins that get dissolved in the GI fluid when comes in contact with Activated charcoal gets absorbed and is passed out.
• Recommended to be administered within 1 hour of toxin ingestion (in severe intoxications a delayed administration of activated charcoal is acceptable)
• Dose: 1g/kg maximum of 50g or 10:1 (activated charcoal: toxin – provided the amount of toxin ingested is known)
• Description of activated charcoal can occur in GI tract, but it’s less when the activated charcoal is present in adequate doses.

Preparations

Contraindications

• Loss of airway reflexes and the patient is not intubated (chance of aspiration)
• Caustic ingestion (activated charcoal doesn’t adsorb caustic, endoscopy is needed for further management, GI perforation)
• Hydrocarbon ingestion (increased chance of aspiration)

Multiple Dose activated charcoal

• To prevent ongoing absorption of toxin I the GI system (extended-release preparations)
• To prevent enterohepatic recirculation (gut dialysis)

Indications

• Severe toxicity of Amanita phalloides, amiodarone, theophylline, carbamazepine, dosulepin, duloxetine, phenobarbital, diquat, lamotrigine, verapamil, valproic acid, quinine, colchicine.

Contraindications

Any Contraindication for single dose activated charcoal

Dosing