Activated charcoal (medication)

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Activated charcoal
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Activated charcoal for medical use
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Trade names CharcoAid, others
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administration 		by mouth, nasogastric tube
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Activated charcoal, also known as activated carbon, is a medication used to treat poisonings that occurred by mouth. [1] To be effective it must be used within a short time of the poisoning occurring, typically an hour. [1] [2] It does not work for poisonings by cyanide, corrosive agents, iron, lithium, alcohols, or malathion. [2] It may be taken by mouth or given by a nasogastric tube. [3] Other uses include inside hemoperfusion machines. [1]

Contents

Common side effects include vomiting, black stools, diarrhea, and constipation. [1] A more serious side effect, pneumonitis, may result if aspirated into the lungs. [1] [2] Gastrointestinal obstruction and ileus are less common but serious adverse effects. [1] Use in pregnancy and breastfeeding is generally safe. [3] Activated charcoal works by adsorbing the toxin. [1]

While charcoal has been used since ancient times for poisonings, activated charcoal has been used since the 1900s. [4] [5] It is on the World Health Organization's List of Essential Medicines. [6]

Medical uses

Poison ingestion

Activated charcoal is used to treat many types of oral poisonings such as phenobarbital and carbamazepine. [7] It is not effective for a number of poisonings including: strong acids or bases, iron, lithium, arsenic, methanol, ethanol or ethylene glycol. [7]

Although activated charcoal is the most commonly used agent for GI decontamination in poisoned patients, medical professionals use discretion when determining whether or not its use is indicated. [7] In a study of acute poisonings from agricultural pesticides and yellow oleander seeds, the administration of activated carbon did not affect survival rates. [8]

Charcoal biscuits were sold in England starting in the early 19th century, originally as remedy to flatulence and stomach trouble. [9]

Tablets or capsules of activated carbon are used in many countries as an over-the-counter drug to treat diarrhea, indigestion, and flatulence. [10] There is some evidence of its effectiveness to prevent diarrhea in cancer patients who have received irinotecan. [11] It can interfere with the absorption of some medications, and lead to unreliable readings in medical tests such as the guaiac card test. [12] Activated carbon is also used for bowel preparation by reducing intestinal gas content before abdominal radiography to visualize bile and pancreatic and renal stones. A type of charcoal biscuit has also been marketed as a pet care product.[ citation needed ]

Other

Claims that activated charcoal will do things such as whiten teeth, cure alcohol-induced hangovers, and prevent bloating, are not supported by evidence. [13] [14] Activated charcoal cleanses also lack evidence and are considered pseudoscience. [15]

Side effects

Incorrect application (e.g. into the lungs) results in pulmonary aspiration which can sometimes be fatal if immediate medical treatment is not initiated. [16] The use of activated carbon is contraindicated when the ingested substance is an acid, an alkali, or a petroleum product.[ citation needed ]

Mechanism of action

In cases of suspected poisoning, medical personnel administer activated carbon on the scene or at a hospital's emergency department. In rare situations, it may also be used in a hemoperfusion system to remove toxins from the blood stream of poisoned patients. Activated carbon has become the treatment of choice for many poisonings, and other decontamination methods such as ipecac-induced emesis or stomach pumping are now used rarely.[ citation needed ]

History

The use of charcoal as a medicinal product can be traced back to Egypt in 1500 BC, where it was used to neutralise bad odours from wounds. By 400 BC, the Phoenicians used charcoal to improve the taste of water stored on ships by containing the water in charred barrels, indicating that an understanding of charcoal's ability to adsorb undesirable chemicals was present by this time. Activated charcoal in its current form was developed during the 18th century, first being used during the sugar refining process to remove coloured impurities from raw sugar. [17] Medical use of activated charcoal commenced in the early 19th century; an often-cited experiment demonstrating its properties was carried out in 1835, where a dosage of strychnine mixed with activated charcoal resulted in no symptoms of poisoning being observed. [18]

Related Research Articles

<span class="mw-page-title-main">Poison</span> Substance that causes death, injury or harm to organs

A poison is any chemical substance that is lethal to living organisms. The term is used in a wide range of scientific fields and industries, where it is often specifically defined. It may also be applied colloquially or figuratively, with a broad sense.

<span class="mw-page-title-main">Atropine</span> Anticholinergic medication used as antidote for nerve agent poisoning

Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically given intravenously or by injection into a muscle. Eye drops are also available which are used to treat uveitis and early amblyopia. The intravenous solution usually begins working within a minute and lasts half an hour to an hour. Large doses may be required to treat some poisonings.

An antidote is a substance that can counteract a form of poisoning. The term ultimately derives from the Greek term φάρμακον ἀντίδοτον (pharmakon antidoton), "(medicine) given as a remedy". Antidotes for anticoagulants are sometimes referred to as reversal agents.

<span class="mw-page-title-main">Strychnine</span> Poisonous substance used as pesticide

Strychnine is a highly toxic, colorless, bitter, crystalline alkaloid used as a pesticide, particularly for killing small vertebrates such as birds and rodents. Strychnine, when inhaled, swallowed, or absorbed through the eyes or mouth, causes poisoning which results in muscular convulsions and eventually death through asphyxia. While it is no longer used medicinally, it was used historically in small doses to strengthen muscle contractions, such as a heart and bowel stimulant and performance-enhancing drug. The most common source is from the seeds of the Strychnos nux-vomica tree.

<span class="mw-page-title-main">Activated carbon</span> Form of carbon with an extremely high surface area

Activated carbon, also called activated charcoal, is a form of carbon commonly used to filter contaminants from water and air, among many other uses. It is processed (activated) to have small, low-volume pores that greatly increase the surface area available for adsorption or chemical reactions.. Activation is analogous to making popcorn from dried corn kernels: popcorn is light, fluffy, and its kernels have a high surface-area-to-volume ratio. Activated is sometimes replaced by active.

<span class="mw-page-title-main">Syrup of ipecac</span> Plant-derived drug used for airway decongestion and to induce vomiting

Syrup of ipecac, or simply ipecac, is a drug that was once widely used as an expectorant and a rapid-acting emetic. It is obtained from the dried rhizome and roots of the ipecacuanha plant, from which it derives its name. It is no longer regularly used in medicine.

<span class="mw-page-title-main">Ergometrine</span> Lysergamide

Ergometrine, also known as ergonovine and sold under the brand names Ergotrate, Ergostat, and Syntometrine among others, is a medication used to cause contractions of the uterus to treat heavy vaginal bleeding after childbirth. It can be used either by mouth, by injection into a muscle, or injection into a vein. It begins working within 15 minutes when taken by mouth and is faster in onset when used by injection. Effects last between 45 and 180 minutes.

<span class="mw-page-title-main">Abrin</span> Chemical compound

Abrin is an extremely toxic toxalbumin found in the seeds of the rosary pea, Abrus precatorius. It has a median lethal dose of 0.7 micrograms per kilogram of body mass when given to mice intravenously. The median toxic dose for humans ranges from 10 to 1000 micrograms per kilogram when ingested and is 3.3 micrograms per kilogram when inhaled.

<span class="mw-page-title-main">Etoposide</span> Chemotherapy medication

Etoposide, sold under the brand name Vepesid among others, is a chemotherapy medication used for the treatments of a number of types of cancer including testicular cancer, lung cancer, lymphoma, leukemia, neuroblastoma, and ovarian cancer. It is also used for hemophagocytic lymphohistiocytosis. It is used by mouth or injection into a vein.

<span class="mw-page-title-main">Irinotecan</span> Cancer medication

Irinotecan, sold under the brand name Camptosar among others, is an anti-cancer medication used to treat colon cancer and small cell lung cancer. For colon cancer it is used either alone or with fluorouracil. For small cell lung cancer it is used with cisplatin. It is given intravenously.

<span class="mw-page-title-main">Trichothecene</span> Large family of chemically related mycotoxins

The trichothecenes are a large family of chemically related mycotoxins. They are produced by various species of Fusarium, Myrothecium, Trichoderma/Podostroma, Trichothecium, Cephalosporium, Verticimonosporium, and Stachybotrys. Chemically, trichothecenes are a class of sesquiterpenes.

<i>Aconitum carmichaelii</i> Species of plant


Aconitum carmichaelii is a species of flowering plant of the genus Aconitum, family Ranunculaceae. It is native to East Asia and eastern Russia. It is commonly known as Chinese aconite, Carmichael's monkshood or Chinese wolfsbane. In Mandarin Chinese, it is known as fùzǐ and as wūtóu ; while in Japanese it is named torikabuto.

<span class="mw-page-title-main">Lubiprostone</span> Medication used for constipation

Lubiprostone, sold under the brand name Amitiza among others, is a medication used in the management of chronic idiopathic constipation, predominantly irritable bowel syndrome-associated constipation in women and opioid-induced constipation. The drug is owned by Mallinckrodt and is marketed by Takeda Pharmaceutical Company.

The consumption of grapes and raisins presents a potential health threat to dogs. Their toxicity to dogs can cause the animal to develop acute kidney injury with anuria. The phenomenon was first identified by the Animal Poison Control Center (APCC), run by the American Society for the Prevention of Cruelty to Animals (ASPCA). Approximately 140 cases were seen by the APCC in the one year from April 2003 to April 2004, with 50 developing symptoms and seven dying.

Hemoperfusion or hæmoperfusion is a method of filtering the blood extracorporeally to remove a toxin. As with other extracorporeal methods, such as hemodialysis (HD), hemofiltration (HF), and hemodiafiltration (HDF), the blood travels from the patient into a machine, gets filtered, and then travels back into the patient, typically by venovenous access.

<span class="mw-page-title-main">Tricyclic antidepressant overdose</span> Medical condition

Tricyclic antidepressant overdose is poisoning caused by excessive medication of the tricyclic antidepressant (TCA) type. Symptoms may include elevated body temperature, blurred vision, dilated pupils, sleepiness, confusion, seizures, rapid heart rate, and cardiac arrest. If symptoms have not occurred within six hours of exposure they are unlikely to occur.

<span class="mw-page-title-main">Salicylate poisoning</span> Medical condition

Salicylate poisoning, also known as aspirin poisoning, is the acute or chronic poisoning with a salicylate such as aspirin. The classic symptoms are ringing in the ears, nausea, abdominal pain, and a fast breathing rate. Early on, these may be subtle, while larger doses may result in fever. Complications can include swelling of the brain or lungs, seizures, low blood sugar, or cardiac arrest.

<span class="mw-page-title-main">Intravenous sodium bicarbonate</span> Pharmaceutical drug

Intravenous sodium bicarbonate, also known as sodium hydrogen carbonate, is a medication primarily used to treat severe metabolic acidosis. For this purpose it is generally only used when the pH is less than 7.1 and when the underlying cause is either diarrhea, vomiting, or the kidneys. Other uses include high blood potassium, tricyclic antidepressant overdose, and cocaine toxicity as well as a number of other poisonings. It is given by injection into a vein.

Carbamate poisoning is poisoning due to exposure to carbamates, which are commonly sold as pesticides around the world. In most respects, it is similar to organophosphate poisoning, though typically less severe or requiring a larger amount of the chemical before symptoms appear.

<span class="mw-page-title-main">Activated charcoal cleanse</span> Pseudoscientific use of medicine

Activated charcoal cleanses, also known as charcoal detoxes, are a pseudoscientific use of a proven medical intervention. Activated charcoal is available in powder, tablet and liquid form. Its proponents claim the use of activated charcoal on a regular basis will detoxify and cleanse the body as well as boost one's energy and brighten the skin. Such claims violate basic principles of chemistry and physiology. There is no medical evidence for any health benefits of cleanses or detoxes via activated charcoal or any other method. Charcoal, when ingested, will absorb vitamins and nutrients as well as prescription medications present in the gastrointestinal tract which can make it dangerous to use unless directed by a medical doctor.

References

  1. 1 2 3 4 5 6 7 "Charcoal, Activated". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. Retrieved 8 December 2016.
  2. 1 2 3 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 57. hdl: 10665/44053 . ISBN   9789241547659.
  3. 1 2 Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 469. ISBN   9781284057560.
  4. ↑ Cecen F, Aktas Ö (2011-09-19). "1". Activated Carbon for Water and Wastewater Treatment: Integration of Adsorption and Biological Treatment. John Wiley & Sons. ISBN   9783527639458. Archived from the original on 2016-12-20.
  5. ↑ Tascón JM (2012). Novel Carbon Adsorbents. Elsevier. p. 640. ISBN   9780080977447. Archived from the original on 2016-12-20.
  6. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  7. 1 2 3 "Charcoal, Activated". The American Society of Health-System Pharmacists. Archived from the original on 22 May 2014. Retrieved 23 April 2014.
  8. ↑ Eddleston M, Juszczak E, Buckley NA, Senarathna L, Mohamed F, Dissanayake W, et al. (February 2008). "Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial". Lancet. 371 (9612): 579–587. doi:10.1016/S0140-6736(08)60270-6. PMC   2430417 . PMID   18280328.
  9. ↑ Rolland JL (2006). The Food Encyclopedia: Over 8,000 Ingredients, Tools, Techniques and People. Robert Rose. p. 148. ISBN   0-7788-0150-0.
  10. ↑ Stearn M (2007). Warts and all: straight talking advice on life's embarrassing problems. London: Murdoch Books. p. 333. ISBN   978-1-921259-84-5. Archived from the original on 2017-09-10. Retrieved 2009-05-03.
  11. ↑ Michael M, Brittain M, Nagai J, Feld R, Hedley D, Oza A, et al. (November 2004). "Phase II study of activated charcoal to prevent irinotecan-induced diarrhea". Journal of Clinical Oncology. 22 (21): 4410–4417. doi: 10.1200/JCO.2004.11.125 . PMID   15514383.
  12. ↑ Gogel HK, Tandberg D, Strickland RG (September 1989). "Substances that interfere with guaiac card tests: implications for gastric aspirate testing". The American Journal of Emergency Medicine. 7 (5): 474–480. doi:10.1016/0735-6757(89)90248-9. PMID   2787993.
  13. ↑ Brooks JK, Bashirelahi N, Reynolds MA (September 2017). "Charcoal and charcoal-based dentifrices: A literature review". Journal of the American Dental Association. 148 (9): 661–670. doi:10.1016/j.adaj.2017.05.001. PMID   28599961.
  14. ↑ "Can activated charcoal help with hangovers?". WebMD. Retrieved 13 March 2019.
  15. ↑ Medlin S (12 June 2018). "Activated charcoal doesn't detox the body – four reasons you should avoid it". The Conversation. Archived from the original on 13 June 2018. Retrieved 26 November 2019.
  16. ↑ Elliott CG, Colby TV, Kelly TM, Hicks HG (September 1989). "Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal". Chest. 96 (3): 672–674. doi:10.1378/chest.96.3.672. PMID   2766830.
  17. ↑ "Charcoal is one of the most important substances ever discovered". Office for Science and Society. Retrieved 2023-08-02.
  18. ↑ Derlet RW, Albertson TE (October 1986). "Activated charcoal--past, present and future". The Western Journal of Medicine. 145 (4): 493–496. PMC   1306980 . PMID   3538661.
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