Why does activated charcoal contain sorbitol

However, because the doses given were subtoxic, it is difficult to extrapolate to an overdose. Unfortunately, randomized clinical studies evaluating outcome after drug overdose are very difficult to perform and standardize, and until recently show little clinical evidence of benefit.

Activated charcoal has long been employed in the treatment of poisoned patients under the assumption that it is a safe therapy. Yet this assumption is under challenge. The precise frequency of these complications is unknown. Certainly the medical literature is not overflowing with case reports documenting adverse reactions occurring with charcoal use. Supporters of charcoal point to this relative paucity documenting harm from charcoal as evidence that charcoal is safe.

However, there is no central registry to report such complications. Attempts to publish case reports purporting to show harm from activated charcoal may be subject to editorial bias and thus remain unpublished. Seger 8 has attempted to summarize the literature reports of adverse events associated with charcoal, including deaths associated with aspiration of charcoal. If this is the case, and benefit cannot be demonstrated, the practice of administering SDAC should be abandoned in the mild to moderately poisoned patient.

Some toxicologists do not believe that charcoal causes pulmonary aspiration. These experts maintain that charcoal is inert and that aspiration is more likely caused by the drug or poison, and may have occurred in the absence of charcoal administration.

They also note a case report in which aspirated charcoal was followed by death from bronchiolitis obliterans in which massive amounts of charcoal were histologically found within the scar tissue of a foreign body reaction.

Activated charcoal can bind many drugs and poisons in vitro, and in vivo can decrease gastrointestinal absorption. While outcome has not been shown to be changed by charcoal in studies to date with the possible exception of yellow oleander , this may be possible when it is used properly in the correct situation. On the other hand, the hazards of activated charcoal use may not be fully appreciated, and the medical literature may not represent a complete picture of complications caused, past or future.

Physicians should consider using activated charcoal in the treatment of selected poisoned patients with severe or potentially severe intoxications where improved outcome is possible.

We recommend health care providers consider using activated charcoal in conjunction with a specialist in poison information or a medical toxicologist. Disclaimer: This website is designed to be informational and educational. Under no circumstance is this website meant to replace the expert advice of a qualified poison specialist or physician.

In phase 1 of the study, subjects consumed 2. Urine was collected for 48 hours and analyzed for quantitative salicylate metabolites. Phase 2 was identical except that 1.

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Our Housecall e-newsletter will keep you up-to-date on the latest health information. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Do not use this product unless directed by a health professional, if turpentine, corrosives, such as alkalies lye and strong acids, or petroleum distillates, such as kerosene, gasoline, paint thinner, cleaning fluid or furniture polish, have been ingested.

This product is not recommended for use in children weighing less than 32 kg, or during multiple dose activated charcoal therapy since excessive catharsis and significant fluid and electrolyte abnormalities may occur. Activated charcoal is produced by pyrolysis of organic material, such as wood, and an activation process which cleanses and fragments the charcoal by exposure to an oxidizing gas compound of steam, oxygen, and acids at high temperatures resulting in increased surface area through the creation of numerous external and internal pores.

These pores serve as reservoirs to adsorb substances admixed with activated charcoal, making it a useful adsorbent for specified toxins. Activated charcoal is pharmacologically inert and is not absorbed in the gastrointestinal tract. Much of the published scientific literature which studied the adsorptive capacity of activated charcoal was conducted using in vitro models. A considerable amount of the research may be invalid since the effects of physiologic pH were not taken into consideration or held constant.

Using research models which simulate the gastric environment, some toxins were not adsorbed by activated charcoal. This data was inappropriately extended to imply that activated charcoal did not adsorb a toxin and therefore had no efficacy in the management of that type of poisoning incident.

However, the research failed to consider that the increased pH of the small intestine provides a receptive environment for the adsorption of the toxin by activated charcoal. Activated charcoal will effectively adsorb acidic, alkaline and neutral substances not to suggest use of activated charcoal in poisonings caused by corrosive agents 2. The extent of adsorption will be dependent upon the relative solubility of the drug at a specified pH.

The optimal dosage ratio of activated charcoal to toxin is described as Furthermore, a primary application of activated charcoal is in adult patients who have intentionally ingested a toxin for drug abuse or suicidal purposes. These patients may not freely provide information about the substance or amount ingested, or have a decreased level of consciousness.

Under these conditions it is difficult to determine the ingestion history, making it impractical to use the ratio. The ratio is also impractical when large amounts of toxin have been ingested i. Gastric contents may also compete with ingested toxins and compromise the adsorption of the toxins by activated charcoal. Under appropriate physiologic conditions activated charcoal adsorbs toxins instantaneously. This adsorptive process is reversible and an equilibrium between free and bound toxin will exist.

According to the law of mass action the amount of free drug decreases as the dose of activated charcoal increases. Therefore, large doses of activated charcoal can favor the equilibrium toward greater toxin adsorption and efficacy. There is limited evidence that desorption of a toxin from activated charcoal may occur.