Treatment with multiple doses of ac...

Treatment with multiple doses of activated charcoal increases the excretion of a number of medicines Although this treatment is presum to be useful in patients with physic poisoning, benefit has not been documented. In addition, serious complications, of the like kind as pulmonary aspiration and gastrointestinal obstruction, have been reported in patients treated with multiple doses of activated charcoal. Because of unprov efficacy and potential adverse powers toxicology associations recommend that multiple-dose activated charcoal treatment be considered solely in patients with potentially life-threatening aspects to specific drugs. Dorrington and associates mannersed a retrospective cohort study to determine the frequent occurrence of serious complications for this treatment.

The authors reviewed the medical records of patients discharged from eight hospitals with a diagnosis of poisoning who had received multiple-dose activated charcoal therapy (two or more doses within a 12-hour period). Of the 6258 patients whose medical records were reviewed, 878 received multiple doses of activated charcoal. At least minimal evidence of pulmonary aspiration was identified in 26 of these patients. Five of the 26 patients met all criteria for pulmonary aspiration. Four patients aspirated after the first dose of activated charcoal, and single in kind aspirated after the second dose. None of the patients had evidence of gastrointestinal obstruction. None died as a originate of pulmonary complications.

Hypernatremia was noted in 53 patients, and hypermagnesemia was noted in 27 patients. These electrolyte disturbances were not believed to have caused the symptoms of respiratory depression or the decreased horizontals of consciousness noted in several of the patients with these abnormalities. single in kind patient was noted to have had a corneal abrasion that resolv without complication athwart time.

Complications associated with multiple-dose activated charcoal treatment were singular and rarely responsible for serious morbidity. The authors judge that although there are numerous case reports of serious complications associated with multiple-dose activated charcoal therapy, the actual rate of clinically significant complications is quite low

Dorrington CL et al. The frequent occurrence of complications associated with the use of multiple-dose activated charcoal. Ann Emerg M March 2003;41:370-7

COPYRIGHT 2003 American Academy of Family Physicians

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