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Activated Charcoal

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Anaesthetics and Critical Care

Obstetrics Gynaecology

Trauma and Orthopaedics

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Urology

Version Jan 2023

Caution in Comatose/Drowsy patients at risk of aspiration so ensure airway protected so involve anaesthetists

About: Always check the BNF link here

Lack of clear evidence of benefit in many episodes of toxicity

Mode of action

Surface area in excess of 1500 m²/g.
Multiple-dose activated charcoal is thought to produce its beneficial effect by interrupting the enteroenteric
Can also interrupt enterohepatic and the enterogastric circulation of drug

Dosing

Single dose of 50g with water (salicylates/paracetamol)
Repeated doses (50g/4h) to increase elimination of some drugs from the blood

Indications for repeated dosing is Toxicity due to

Carbamazepine, Dapsone, phenobarbital
Quinine, Theophylline, Phenytoin, Digoxin,
Paracetamol, Aspirin - useful with salicylates
Teriflunomide and Leflunomide

Do Not use with

Petroleum products, corrosives,
Alcohols, clofenotane, malathion
Metal salts (eg iron, lithium)

Dose range:You must check with BNF or drug datasheet

Name	Starting Dose	Frequency	Route
Activated Charcoal	50 g	Stat	PO/NG
Activated Charcoal (Eliminate poison)	50 g then 50 g ever 4 hrs (or 25 mg every 2 hours or 12.5 g every hour)	Stat	PO/NG
Activated Charcoal (Eliminate Teriflunomide)	50 g	12-hourly	PO for 11 days
Activated Charcoal (Eliminate Leflunomide)	50 g	6-hourly	PO for 11 days

Side effects

Constipation

References

Activated Charcoal at BNF

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. The official launch will be at the end of 2018. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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