Single-Dose or Multiple-Dose Regimens for Treatment of Poisoning in Childrenġ0–25 g initially, then 1–2 g/kg every 2–4 hoursĥ0–100 g initially, then 12.5 g every hour, 25 g every 2 hours, or 50 g every 4 hours Dosage Pediatric Patients Poisonings Oral ReconstitutionĮxtemporaneously, mix powder with sufficient tap water (e.g., 20–30 g in at least 240 mL) to form a slurry. Sorbitol may be administered with single-dose activated charcoal or with first dose of multiple-dose regimen for palatability and laxative action additional suspending and flavoring agents generally not recommended. If an antiemetic is required to successfully administer high dosages, a serotonin type 3 ( 5-HT 3) receptor antagonist (e.g., ondansetron) or metoclopramide may be preferred. If help from a poison control center (80), emergency medical facility (911), or other qualified health professional cannot be obtained quickly by medically unsupervised individuals attempting to manage acute poisoning, follow directions on the container of activated charcoal.Īdminister activated charcoal powder orally or via nasogastric or orogastric tube as extemporaneously prepared slurry or suspension or commercially available suspension.Ĭontinuous nasogastric infusion or division of the total dose into smaller amounts given more frequently may improve tolerance of large doses. Tablets or granules of activated charcoal are less effective than powder and should not be used in the treatment of poisonings. Also may be considered for life-threatening ingestions of phenobarbital, carbamazepine, quinine, dapsone, theophylline, paraquat, or Amanita phalloides. Multiple-dose regimens may be considered for drugs that undergo enterohepatic or enteroenteric circulation, those with a small volume of distribution, those that are not extensively protein bound, and those with a low endogenous clearance. Most effective when administered early, preferably within 30–60 minutes of poison ingestion. Charcoal, Activated Dosage and Administration General Poisonings Has been used in dressings for suppurating wounds or ulcers to decrease odor and promote healing. Has been used alone or combined with kaolin in the management of diarrhea, but value has not been established. GI DisordersĪdsorption of intestinal gases in the treatment of flatulence, intestinal distention, and dyspepsia FDA classified as lacking substantial evidence of efficacy as antiflatulent or digestive aid. Hemoperfusion through columns of activated charcoal to remove endogenous or exogenous toxins in uremia, hepatic failure, or acute toxicity associated with overdose of certain drugs. (See General: Poisonings, under Dosage and Administration.) Hemoperfusion Controlled studies demonstrating reduced morbidity and mortality generally are lacking. Most commonly used agent for GI decontamination in poisoned patients however, routine administration in poisoned patients is not recommended by American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists (AACT/EAPCCT). May be used for treatment (GI decontamination) in most oral poisonings except those involving corrosive agents (e.g., strong acids or alkalis) or substances for which its absorptive capacity is too low to be clinically useful (e.g., iron salts, lithium, boric acid, arsenic, malathion, or organic solvents such as methanol, ethanol, or ethylene glycol). Written by ASHP.Īdsorbent and antidote destructive distillation residue of organic materials with small particle size, treated to increase adsorptive power. Brand names: Actidose, Adsorba, CharcoAid G, Charcoal Plus DS, CharcoCaps,
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