activated charcoal

General

Trade Name(s)

  • Acta-Char Liquid-A
  • Actidose-Aqua
  • Aqueous Charcodote Canadian Tradename
  • Charac-50 Canadian Tradename
  • CharcoAid 2000
  • Charcodote Canadian Tradename
  • Insta-Char
  • Insta-Char Aqueous Suspension
  • Liqui-Char
  • SuperChar Aqueous

Ther. Class.
antidotes

Pharm. Class.
adsorbents

Indications

Acute management of many oral poisonings following emesis/lavage.

Action

Binds drugs and chemicals in the GI tract.

Therapeutic Effect(s):

Decreased intestinal absorption of drugs or chemicals in the overdose situation.

Pharmacokinetics

Absorption: None.

Distribution: None.

Metabolism and Excretion: Excreted unchanged in the feces.

Half-life: Unknown.

TIME/ACTION PROFILE (antidote)

ROUTEONSETPEAKDURATION
POwithin minunknown4–12 hr

Contraindication/Precautions

Contraindicated in:

  • No known contraindications.

Use Cautiously in:

  • Poisonings due to cyanide, corrosives, ethanol, methanol, petroleum distillates, organic solvents, mineral acids, or iron
  • Endoscopic examination (observation will be obscured).

Adverse Reactions/Side Effects

GI: black stools, constipation, diarrhea, vomiting

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Drug-Drug

 Other drugs  including  ipecac syrup  and laxatives  will be adsorbed by charcoal and as a result will not be systemically absorbed from the GI tract.

Drug-Food:

Milk, ice cream, or sherbet will decrease the ability of charcoal to absorb other agents.

Route/Dosage

Antidote

PO (Adults): 25–100 g (may be repeated q 4–6 hr).

PO (Children  1–12 yr): 25–50 g (may be repeated q 4–6 hr).

PO (Children  <1 yr): 1 g/kg (may be repeated q 4–6 hr).

Availability (generic available)

Powder: 15-, 25- 30- Canadian Tradename, 40-, 120-, 125-g 240-gOTC  containers

Oral suspension: 12.5 g/60 mLOTC, 15 g/72 mLOTC, 15 g/120 mLOTC, 25 g/120 mLOTC, 30 g/120 mLOTC, 50 g/240 mLOTC, 15 g/120 mLOTC, 25 g/125 mLOTC, 50 g/225 mLOTC, 50 g/250 mLOTC

In combination with: sorbitol (Actidose with Sorbitol), Charcoaid, Pediatric Charcodote Canadian Tradename, Charac-tol Canadian Tradename, (Charcodote TFS)OTC Canadian Tradename

Assessment

  • Assess neurologic status; administer only if patient is alert (unless airway is protected).
  • Inquire as to the type of drug or poison and time of ingestion.
  • Consult reference, poison control center, or physician for symptoms of toxicity of ingested agent(s).
  • Monitor BP, pulse, respiratory and neurologic status, and urine output as indicated by toxicity of agent(s). Notify physician if symptoms persist or worsen.

Lab Test Considerations:

Chronic use may impair absorption of essential nutrients. This may result in decreased mineral or electrolyte levels.

Potential Diagnoses

Implementation

  • Treatment of Poisoning:

    Activated charcoal is most effective if administered within 30 min of ingestion of drug or poison. Dosage may be repeated for drugs subjected to enterohepatic elimination to minimize further absorption.

    • If syrup of ipecac is used, administer ipecac first and wait until emesis occurs before administering activated charcoal.
  • PO 

    Mix dose in 6–8 oz water; administer as a slurry (unless using suspension with or without sorbitol). Do not administer with milk products (milk, ice cream, or sherbet). May need to be diluted with additional water to be thin enough to administer through a nasogastric tube.

    • Shake oral suspension well before administration.
    • Rapid ingestion may cause vomiting. If vomiting occurs shortly after administering dose, confer with physician about repeating dose.
    • Do not administer other oral drugs for 2 hr before or after administering activated charcoal.
    • Slurry is constipating; physician may order a laxative to speed removal of the drug. May not be required with products containing sorbitol.

Patient/Family Teaching

  • Inform patient that stools will turn black.
  • Poisoning: When counseling, discuss methods of prevention, need to confer with poison control center, physician, or emergency department before administering, and need to bring ingested substance to emergency department for identification.

Evaluation/Desired Outcomes

Prevention or resolution of toxic effects of ingested agent.

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