Charcoal tablets

Gastric lavage should be carried out immediately if oral consumption is suspected. In order to hasten intestinal elimination charcoal tablets should be administered at 4-hr intervals with sodium sulfate as laxative. To activate the antimony the chelating agent Sulfactin must be administered intramuscularly and also about every 4 hr. Chelated antimony is excreted renally and is readily dialyzed. Hence continuous hemodialysis can be carried out if necessary. The administration of Sulfactin must be continued throughout the whole dialysis. The intravenous administration of lasix with a balanced substitution of electrolyte solutions to force diuresis is also promising in cases of very high levels of Sb intoxication [33]. 

Contraindications for antipsychotic therapy are few they may include Parkinson s disease, hepatic failure, hypotension, bone marrow depression, or use of CNS depressants. Overdoses of antipsychotics are rarely fatal, except for thioridazine, which is associated with major ventricular arrhythmias, cardiac conduction block, and sudden death. For other agents gastric lavage should be attempted even if several hours have elapsed since the drug was taken, because gastrointestinal motility is decreased and the tablets may still be in the stomach. Moreover, activated charcoal effectively binds most of these drugs and can be followed by a saline cathartic. The hypotension often responds to fluid replacement or pressor agents such as norepinephrine. 

Manufacturing materials can and often are a source of contamination. Various materials, such as filtering aids and charcoal, are used especially in chemical synthesis of active ingredients. These materials can carry over to the finishedproduct and can represent a significant source of contamination. For many years, companies would occasionally see tiny black spots on white tablets. Often those black spots could be traced using very sensitive analytical techniques back to the active ingredient and positively identified... 

Tenamfetamine ( ecstasy, MDMA methylenedioxymethamphetamine) is structurally related to mescaline as well as to amphetamine. It was originally patented in 1914 as an appetite suppressant and has recently achieved widespread popularity as a dance drug at rave parties (where it is deemed necessary to keep pace with the beat and duration of the music popular names reflect the appearance of the tablets and capsules and include White Dove, White Burger, Red and Black, Denis the Menace). Tenamfetamine stimulates central and peripheral a-and p-adrenoceptors thus the pharmacological effects are compounded by those of physical exertion, dehydration and heat. In susceptible individuals (poor metabolisers who exhibit the CYP450 2D6 polymorphism) a severe and fatal idiosyncratic reaction may occur with fulminant hyperthermia, convulsioirs, disseminated intravascular coagulation, rhabdomyolysis, and acute renal and hepatic failure. Treatment includes activated charcoal, diazepam for convulsions, P-blockade (atenolol) for tachycardia, a-blockade (phentolamine) for hypertension, and dantrolene if the rectal temperature exceeds 39°C. 

A 73-year-old man took an unknown number of theophylline modified-release tablets and furosemide 40 mg tablets. He developed a tachydysrhythmia, vomiting, and restlessness. His maximum theophylline concentration was 67 pg/ml and he had hypokalemia (2.8 mmol/1) and hyponatremia (123 mmol/1). The maximum creatine kinase activity was (32 mol/1 [sic]) and the serum myoglobin concentration was 3789 pg/l. He was treated with oral activated charcoal, continuous venovenous hemodialysis, intravenous potassium and sodium chloride, forced diuresis, and continuous intravenous meto-prolol, and survived without sequelae. 

The best charcoal for use in black powder is the softwood type sold as "willow dust" by suppliers of pyrotechnic chemicals. As a substitute, hardwood charcoal can be used, such as by pulverising charcoal briquettes or even the charcoal stomach tablets for relief of flatulence. For the best powder, however, the softwood variety is recommended ) ... 

Activated charcoal absorbs toxin and is excreted in feces. Activated charcoal is available in tablets, capsules, or suspension, and is the primary treatment for ingestion of caustic toxins, which would injure the esophagus if regurgitated. 

In cases where vomiting is contraindicated, the patient should be administered activated charcoal, which is available in tablets, capsules, or suspension. Charcoal absorbs (detoxifies) ingested toxic substances, irritants, and intestinal gas. Activated charcoal can be given as a slurry (30 grams in at least 8 oz. of water) or 12.5-50 grams in aqueous or sorbitol suspension. It is usually given as a single dose. 

F. Repeat-dose activated charcoal. Repeated doses of activated charcoal (20-30 g or 0.5-1 g/kg every 2-3 hours) are given orally or via gastric tube. The presence of a slurry of activated charcoal throughout several meters of the intestinal lumen reduces blood concentrations by intermpting enterohep-atic or enteroenteric recirculation of the dmg or toxin, a mode of action quite distinct from simple adsorption of ingested but unabsorbed tablets. This technique is easy and noninvasive and has been shown to shorten the half-life of phenobarbital, theophylline, and several other dmgs (Table 1-41). However, it has not been shown in clinical trials to alter patient outcome. Caution Re-peat-dose charcoal may cause serious fluid and electrolyte disturbance secondary to large-volume diarrhea, especially if premixed charcoal-sorbitol suspensions are used. Also, It should not be used in patients with ileus or obstmction. 

In health care facilities, ipecac is rarely indicated but may find occasional use In patients with recent ingestions involving substances poorly adsorbed by activated charcoal (eg, iron, lithium, potassium, and sodium) or sustained-release or enteric-coated tablets. 

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