Activated charcoal (medication)
Activated charcoal, or activated carbon, is used as a medication to treat poisonings following excessive oral ingestion of certain medications or poisons. Side effects may include aspiration into the lungs.
It is on the World Health Organization's List of Essential Medicines, a list of the most important medications needed in a basic health system.
While it is used to treat many types of oral poisonings, there is no good evidence that it improves outcomes. It is not effective for a number of poisonings including: strong acids or bases, iron, lithium, arsenic, methanol, ethanol or ethylene glycol. In a study of acute poisonings from agricultural pesticides and yellow oleander seeds, the administration of activated carbon did not affect survival rates of patients.
Tablets or capsules of activated carbon are used in many countries as an over-the-counter drug to treat diarrhea, indigestion, and flatulence. There is some evidence of its effectiveness to prevent diarrhea in cancer patients who have received irinotecan. It can interfere with the absorption of some medications, and lead to unreliable readings in medical tests such as the guaiac card test. Activated carbon is also used for bowel preparation by reducing intestinal gas content before abdominal radiography to visualize bile and pancreatic and renal stones. A type of charcoal biscuit has also been marketed as a pet care product.
Incorrect application (e.g. into the lungs) results in pulmonary aspiration which can sometimes be fatal if immediate medical treatment is not initiated. The use of activated carbon is contraindicated when the ingested substance is an acid, an alkali, or a petroleum product.
Mechanism of action
Active charcoal binds the poison and prevent its absorption by the gastrointestinal tract. In cases of suspected poisoning, medical personnel administer activated carbon on the scene or at a hospital's emergency department. In rare situations activated carbon is used in Intensive Care to filter out harmful drugs from the blood stream of poisoned patients. Activated carbon has become the treatment of choice for many poisonings, and other decontamination methods such as ipecac-induced emesis or stomach pumping are now used rarely.
Mechanisms of action:
- Binding of the poison to prevent stomach and intestinal absorption. Binding is reversible so a cathartic such as sorbitol may be added as well.
- It interrupts the enterohepatic and enteroenteric circulation of some drugs/toxins and their metabolites.
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