Activated Charcoal

 

Other Names

•Charcodote


Classification

•Poison Antidote (GI)


Action

•Activated Charcoal is a fine black powder that binds and adsorbs ingested toxins

•Once bound to the activated charcoal, the combined complex is excreted from the body


Indications

Many oral poisonings, medication overdoses


Contraindications

Corrosives, caustics, or petroleum distillates (relatively ineffective and may induce vomiting)


Precautions

Use with caution if decreased LOC (ensure airway is protected)


Adverse reactions

•May indirectly induce nausea and vomiting

•May cause constipation


Interactions/Compatibility/Stability

  1. Syrup of Ipecac is adsorbed by activated charcoal


Special Considerations

•Pregnancy safety not established

•Activated charcoal may also be known as AC

•Is relatively insoluble in water

•May blacken feces

•Must be stored in a closed container

•Different charcoal preparations may have varying rates of adsorption

•Does not adsorb all drugs and toxic substances (for example, cyanide, lithium, iron, lead and arsenic)

•If a patient has a decreased LOC, ensure proper airway management to reduce risk of aspiration

•In certain overdoses such as phenobarbital, carbamazepine, theophyline, phenytoin and digitalis, multiple dose charcoal may be required to be effective


Dosages

Preparations:

•25 gm (black powder)/125 ml bottle (200 mg/ml)

•50 gm (black powder)/250 ml bottle (200 mg/ml)

•May come with or without sorbitol

Dosage

•Approximately 5 - 10 times the amount of the poison (larger amounts if food is also present)

Adult:

• 0.5 - 1 gm/kg diluted to a 500 ml aqueous slurry (administered PO or slowly by nasogastric tube)

Pediatric:

• 0.6 - 2 gm/kg diluted to a 250 ml aqueous slurry (administered PO or slowly by nasogastric tube)


Kinetics

Onset             Immediate

Peak              No documentation found

Duration        Continual while in GI tract



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