Post by Trade Coach on Oct 5, 2015 21:41:17 GMT 1
Uses
Activated charcoal is used as an antidote to poisoning, as an antiflatulent, and as a potential treatment for reducing blood lipid concentrations in patients with uremia and diabetes
Dosing
The recommended dosage of activated charcoal for children 1 year of age and younger is 10 to 25 g or 0.5 to 1 g/kg; for children 1 to 12 years of age, the recommended dosage is 25 to 50 g or 0.5 to 1 g/kg; and for adolescents and adults, the recommended dosage is 25 to 100 g.
Contraindications
Single-dose activated charcoal is contraindicated in patients with unprotected airways and decreased levels of consciousness who are not intubated. Activated charcoal is also contraindicated if its use increases the risk and severity of aspiration, particularly with low viscosity, aliphatic hydrocarbons (eg, kerosene, lighter fluid, lamp oil). In cases of hydrocarbons with systemic toxicity (ie, benzene) or coingestion with a systemic toxin, charcoal use may be considered. Patients who are at risk of hemorrhage or GI perforation caused by pathology, recent surgery, or medical conditions could be further compromised by single-dose activated charcoal. The presence of activated charcoal in the GI tract may obscure endoscopic visualization, but a corrosive is not an absolute contraindication when charcoal is used for coingested agents that are systemic toxins. The acronym PHAILS represents the following situations in which activated charcoal use is not helpful, requires caution, or is contraindicated: P–Pesticides, petroleum distillated, unprotected airway; H–Hydrocarbons, heavy metals, greater than 1 hour; A–Acids, alkali, alcohols, altered level of consciousness, aspiration risk; I–Iron, ileus, intestinal obstruction; L–Lithium, lack of gag reflex; S–Solvents, seizures.
Toxicology
Minimal toxicity is associated with the use of charcoal in hemoperfusion.
Charcoal is produced by pyrolysis and high temperature oxidation of organic materials. Animal charcoal is obtained from items such as charred bones, meat, and blood. Activated charcoal is obtained from charred wood or vegetable matter and treated with various substances to increase its adsorptive power. Amorphous carbons (or charcoals) are taken from the incomplete combustion of natural gas, fats, oils, or resins
History
Charcoal has been used for medical purposes for thousands of years. Ancient Egyptian papyri traces the use of charcoal to 1500 BC for the adsorption of odor from rotting wounds. Hindu documents from 450 BC record the use of charcoal and sand filters for the purification of drinking water. Hippocrates and Pliny both describe the use of charcoal to treat epilepsy, cholorosis, and anthrax.
In 1773, the German-Swedish pharmaceutical chemist Carl Scheele recognized the specific adsorptive powers of charcoal with various gases. At a meeting of the French Academy of Sciences in 1831, a pharmacist ingested several times the lethal dose of strychnine with equal amounts of charcoal and survived. However, the Academy members were unimpressed by the demonstration, and charcoal continued to be used for more industrial purposes.
In 1911, the first industrially produced activated charcoal, Eponit , was produced in Austria. Shortly afterward, the use of toxic gases in World War I served as a driving force for the mass production of activated charcoal suitable for respirators. But it was not until 1963, after a review article was published in the Journal of Pediatrics , that activated charcoal became more widely accepted in the management of ingested toxins. 1
Chemistry
The chemistry of charcoal is complex. Although the purest forms essentially consist of all carbon, the small amounts of impurities that remain following combustion of the source material have been difficult to characterize. Medicinal charcoals have been developed with a high surface area-to-weight ratio in order to maximize adsorption capacity.
The adsorptive properties of charcoal can be increased by treatment with substances such as carbon dioxide, oxygen, air, steam, sulfuric acid, zinc chloride, or phosphoric acid (or combinations of these) at high temperatures (500° to 900°C). These materials help remove impurities and reduce the particle size of carbon, allowing more adsorption due to increased surface area. One milliliter of finely subdivided and activated medicinal charcoal has a total surface area of approximately 1,000 m 2 . Medicinal or activated charcoal is a fluffy, fine, black, odorless, and tasteless powder without gritty material. It is insoluble in water or other common solvents but may be suspended for a short time after vigorous shaking.
Source: www.drugs.com/npp/charcoal.html
Activated charcoal is used as an antidote to poisoning, as an antiflatulent, and as a potential treatment for reducing blood lipid concentrations in patients with uremia and diabetes
Dosing
The recommended dosage of activated charcoal for children 1 year of age and younger is 10 to 25 g or 0.5 to 1 g/kg; for children 1 to 12 years of age, the recommended dosage is 25 to 50 g or 0.5 to 1 g/kg; and for adolescents and adults, the recommended dosage is 25 to 100 g.
Contraindications
Single-dose activated charcoal is contraindicated in patients with unprotected airways and decreased levels of consciousness who are not intubated. Activated charcoal is also contraindicated if its use increases the risk and severity of aspiration, particularly with low viscosity, aliphatic hydrocarbons (eg, kerosene, lighter fluid, lamp oil). In cases of hydrocarbons with systemic toxicity (ie, benzene) or coingestion with a systemic toxin, charcoal use may be considered. Patients who are at risk of hemorrhage or GI perforation caused by pathology, recent surgery, or medical conditions could be further compromised by single-dose activated charcoal. The presence of activated charcoal in the GI tract may obscure endoscopic visualization, but a corrosive is not an absolute contraindication when charcoal is used for coingested agents that are systemic toxins. The acronym PHAILS represents the following situations in which activated charcoal use is not helpful, requires caution, or is contraindicated: P–Pesticides, petroleum distillated, unprotected airway; H–Hydrocarbons, heavy metals, greater than 1 hour; A–Acids, alkali, alcohols, altered level of consciousness, aspiration risk; I–Iron, ileus, intestinal obstruction; L–Lithium, lack of gag reflex; S–Solvents, seizures.
Toxicology
Minimal toxicity is associated with the use of charcoal in hemoperfusion.
Charcoal is produced by pyrolysis and high temperature oxidation of organic materials. Animal charcoal is obtained from items such as charred bones, meat, and blood. Activated charcoal is obtained from charred wood or vegetable matter and treated with various substances to increase its adsorptive power. Amorphous carbons (or charcoals) are taken from the incomplete combustion of natural gas, fats, oils, or resins
History
Charcoal has been used for medical purposes for thousands of years. Ancient Egyptian papyri traces the use of charcoal to 1500 BC for the adsorption of odor from rotting wounds. Hindu documents from 450 BC record the use of charcoal and sand filters for the purification of drinking water. Hippocrates and Pliny both describe the use of charcoal to treat epilepsy, cholorosis, and anthrax.
In 1773, the German-Swedish pharmaceutical chemist Carl Scheele recognized the specific adsorptive powers of charcoal with various gases. At a meeting of the French Academy of Sciences in 1831, a pharmacist ingested several times the lethal dose of strychnine with equal amounts of charcoal and survived. However, the Academy members were unimpressed by the demonstration, and charcoal continued to be used for more industrial purposes.
In 1911, the first industrially produced activated charcoal, Eponit , was produced in Austria. Shortly afterward, the use of toxic gases in World War I served as a driving force for the mass production of activated charcoal suitable for respirators. But it was not until 1963, after a review article was published in the Journal of Pediatrics , that activated charcoal became more widely accepted in the management of ingested toxins. 1
Chemistry
The chemistry of charcoal is complex. Although the purest forms essentially consist of all carbon, the small amounts of impurities that remain following combustion of the source material have been difficult to characterize. Medicinal charcoals have been developed with a high surface area-to-weight ratio in order to maximize adsorption capacity.
The adsorptive properties of charcoal can be increased by treatment with substances such as carbon dioxide, oxygen, air, steam, sulfuric acid, zinc chloride, or phosphoric acid (or combinations of these) at high temperatures (500° to 900°C). These materials help remove impurities and reduce the particle size of carbon, allowing more adsorption due to increased surface area. One milliliter of finely subdivided and activated medicinal charcoal has a total surface area of approximately 1,000 m 2 . Medicinal or activated charcoal is a fluffy, fine, black, odorless, and tasteless powder without gritty material. It is insoluble in water or other common solvents but may be suspended for a short time after vigorous shaking.
Source: www.drugs.com/npp/charcoal.html