Must-read: review of single-dose activated charcoal
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Activated charcoal for acute overdose: a reappraisal. Juurlink D. Br J Clin Pharmacol 2015 Sep 26 [Epub ahead of print]
Abstract
The British Journal of Clinical Pharmacology seems to be publishing a series of articles on basic management of the poisoned patient. Several weeks ago we reviewed (and highly recommended) Marco Sivilotti’s excellent discussion of flumazenil, naloxone and the coma cocktail. This current article looking at single-dose activated charcoal (SDAC) is similarly well done, and essential reading.
The author points out that although most poisons bind to activated charcoal some — most notably hydrocarbons, caustics, and the metals lithium and iron — do not. Other factors that might increase the potential benefit of administering SDAC include:
anticipation of severe toxicity
absence of contraindications (such as decreased mental status, unprotected airway, uncooperative patient, ileum, or intestinal obstruction)
lack of effective antidote
ingestion of modified-release formulation
ability to administer a reasonable dose of charcoal (50-100 grams) that will be at least 10-40 times the dose of poison
Although in the absence of contraindications charcoal is relatively safe, there are definite risks, including pulmonary aspiration and intestinal obstruction or perforation. The decision whether or not to treat a poisoned patient with SDAC is a clinical one. An important concept hinted at in the paper is that giving SD...
Source: The Poison Review - Category: Toxicology Authors: Leon Tags: Best of TPR Medical gastric emptying management of poisoned patient Review single dose activated charcoal Source Type: news
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