CHARCOAL, ACTIVATED (LIQUID ANTIDOTE)

CHARCOAL, ACTIVATED (LIQUID ANTIDOTE)
Actidose, CharcoAid, Charcocaps, Charcodote, Insta-Char
Classifications: antidote; adsorbent;
Therapeutic: antidote

Pregnancy Category: C

Availability

208 mg/mL, 15 g, 30 g, 50 mg liquid/suspension

Action

Activated charcoal (carbon) is a chemically inert, odorless, tasteless, fine black powder with wide spectrum of adsorptive activity. Acts by binding (adsorbing) toxic substances, thereby inhibiting their GI absorption, enterohepatic circulation, and thus bioavailability.

Therapeutic Effect

Action appears to result from drug diffusion from plasma into GI tract where it is adsorbed by activated charcoal. Effectively adsorbs toxins in the gut preventing their systemic absorption and impact.

Uses

General purpose emergency antidote in the treatment of poisonings by most drugs and chemicals. Gastric dialysis (repetitive doses) in uremia to adsorb various waste products from GI tract; severe acute poisoning. Has been used to adsorb intestinal gases in treatment of dyspepsia, flatulence, and distension (value in these conditions not established). Sometimes used topically as a deodorant for foul-smelling wounds and ulcers.

Contraindications

Reportedly not effective for poisonings by cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol; gag reflex depression, coma; GI obstruction; quinidine or quinine hypersensitivity; pregnancy (category C).

Cautious Use

Lactation.

Route & Dosage

Acute Poisonings
Adult: PO 30–100 g in at least 180–240 mL (6–8 oz) of water or 1 g/kg
Child (1–12 y): PO 1–2 g/kg or 15–30 g in at least 6–8 oz of water
Infant (<1 y): PO 1 g/kg

Gastric Dialysis
Adult: PO 20–40 g q6h for 1 or 2 d

GI Disturbances
Adult: PO 520–975 mg p.c. up to 5 g/d

Administration

Oral
  • Activated charcoal tablets or capsules are less adsorptive and thus less effective than powder or liquid form; therefore, they are not recommended in treatment of acute poisoning.
  • Drug is most effective when administered as soon as possible after acute poisoning (preferably within 30 min).
  • In an emergency, dose may be approximated by stirring sufficient activated charcoal into tap water to make a slurry the consistency of soup (about 20–30 g in at least 240 mL of water).
  • Activated charcoal can be swallowed or given through a nasogastric tube. If administered too rapidly, patient may vomit.
  • If necessary, palatability may be improved by adding a small amount of concentrated fruit juice or chocolate powder to the slurry. Reportedly, these agents do not appreciably alter adsorptive activity.
  • To prevent adsorption of gases from the air, store in tightly covered container.

Adverse Effects (≥1%)

GI: Vomiting (rapid ingestion of high doses), constipation, diarrhea (from sorbitol).

Interactions

Drug: May decrease absorption of all other oral medications—administer at least 2 h apart.

Pharmacokinetics

Absorption: Not absorbed. Elimination: In feces.

Nursing Implications

Assessment & Drug Effects

  • Record appearance, color, consistency, frequency, and relative amount of stools. Inform patient that activated charcoal will color feces black.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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