Friday, July 16, 2021

Activated Charcoal

EM Ottawa - By Alexandra Hamelin - Juyl 15, 2021
  1. The appropriate dosing of AC is an AC-to-drug ratio of 10:1. This strategy works especially well for smaller ingestions. If the amount that the patient ingested is unknown, a 1g/kg dose of AC is appropriate.
  2. AC can be given up to 2-4 hours post-ingestion if the benefits outweigh the risks. Later administration beyond 4 hours can be considered if other factors exist such as serious toxicity, modified-release product, and delayed gastric emptying.
  3. MDAC should be considered if a patient has ingested a life-threatening amount of drug known to undergo enterohepatic circulation (i.e. carbamazepine, phenobarbital, theophylline)
  4. AC can be considered up to 2 hours after acetaminophen overdose. AC should be more strongly considered in polypharmacy ingestions, and especially in massive acetaminophen ingestion.
  5. The combined approach of AC and WBI is still often employed in dangerous overdoses of sustained-release medications. One approach, based largely on expert opinion, is to give a first dose of AC, wait for the AC to act alone, administer WBI, and then give a second dose of AC 1-2 hours later.