Activated Charcoal

CLASS

  • decontamination agent

MECHANISM OF ACTION

  • absorbing molecules of drug on its surface -> inhibiting their absorption by as much as 50% -> excretion in faeces
  • absorptive area = 3,000m2/g

PHARMACEUTICS

  • odourless, tasteless
  • fine black powder
  • chemically inert form of carbon
  • prepared by pyrolysis of carbonaceous matter (coconut, pulverised peat or sawdust) @ 600-900 C in a kiln without air.
  • then concentrated with zinc chloride solution -> washed off with dilute acid & water -> exposed to steam or CO2 at 600-700 C -> forms an internal maze of pores.

DOSE

  • 1g/kg
  • 50g in 100mL
  • should be given within 1 hr
  • can be given later OD drug not lipid soluble, slow passage to intestine, sustained release preparation or ingested with anti-cholinertics

INDICATIONS

  • give if toxic agent is still within the GI tract (within 1 hour) and potential benefits out weigh risks.
  • useful in overdose from:
  • aspirin
  • paracetamol
  • barbiturates
  • TCA’s
  • digoxin
  • amphetamines
  • morphine
  • cocaine
  • phenothiazines

ADVERSE EVENTS

  • vomiting
  • pulmonary aspiration
  • direct administration to lung via N/G tube -> potentially fatal
  • impaired absorption of oral medications/antidotes
  • corneal abrasions
  • constipation/bowel obstruction

PHARMACOKINETICS

  • Absorption
  • Distribution
  • Metabolism
  • Elimination

EVIDENCE

  • single dose activated charcoal is generally the preferred method of decontamination but does not improve outcome when applied to unselected patients

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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