Charcoal, activated

Oral
Acute oral poisoning

Cyanide, mineral acids, caustic alkalis, organic solvents, iron, ethanol, methanol poisoning; lithium, methionine; intestinal obstruction, anatomically-broken GI tract, haemorrhage or GI perforation. Concomitant use of charcoal with sorbitol: Patients with fructose intolerance; Childn <1 yr.

Decreased peristalsis: administer within 1 hr of ingestion. Induce vomiting of ipecac syr before admin of charcoal to prevent adsorption of ipecac. Petroleum distillate, caustic ingestions may harm gastric lining upon induction of vomiting by charcoal. Limit admin of charcoal in sorbitol doses to prevent loss of fluid and electrolyte. Monitor for active bowel sounds before administering charcoal. Pregnancy.

Vomiting, constipation, diarrhoea, black stools, swelling of abdomen, bowel obstruction; platelet aggregation, charcoal embolism, thrombocytopenia, haemorrhage, hypoglycaemia, hypocalcaemia, hypothermia, hypotension (haemoperfusion with activated charcoal); blackening of teeth and mouth; hypernatraemia, hypokalaemia, hypermagnesemia (with concomitant admin with cathartics).

Reduces absorption of most drugs from GI tract. Decreases effectiveness of methionine via adsorption. Decreases ipecac effect.

Milk products eg, milk, ice crm or sherbet, marmalade reduces charcoal effect. Food, nutritional supplements or herbs must not be taken within two hr of ingestion of charcoal.

Description:
Mechanism of Action: Charcoal due to its large surface area, inhibits the GI absorption of toxic substances or irritants eg, aromatic or benzenoid-type substances through adsorption. As a laxative, the addition of sorbitol provides hyperosmotic environment thus causing catharsis. Moreover, charcoal interferes with the enterohepatic circulation of bile acids resulting to a lower cholesterol level.
Pharmacokinetics:
Absorption: Unabsorbed via the GI tract.
Metabolism: Unmetabolised.
Excretion: Via faeces (as unchanged form).

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