Phenobarbital Charcoal, activated

Efavirenz (Sustiva) [Antiretroviral/NNRTI] Uses Hiv infxns Action Antiretroviral nonnucleoside RTI Dose Adults. 600 mg/d PO qhs Feds. See package insert avoid high-fat meals Caution [D, ] CDC recommends HIV-infected mothers not breast-feed Contra Component sensitivity Disp Caps SE Somnolence, vivid dreams, dizziness, rash, N/V/D Interactions T Effects W/ ritonavir T effects OF CNS depressants, ergot derivatives, midazolam, ritonavir, simvastatin, triazolam, warfarin X effects W/ carbamazepine, phenobarbital, rifabutin, rifampin, saquinavir, St. John s wort i effects OF amprenavir, carbamazepine, clarithromycin, indinavir, phenobarbital, saquinavir, warfarin may alter effectiveness OF OCPs EMS Concurrent EtOH usage can t CNS d ression OD May cause muscle contractions and adverse CNS effects activated charcoal may be effective... 

X effects W/ carbamazepine, nelfmavir, phenobarbital, phenytoin, primidone, rifampin, ritonavir EMS Use CNS depressants w/ caution concurrent EtOH use can T resp depression, may T QT interval, monitor ECG OD May cause miosis, CNS and resp depression, hypotension, bradycardia, and CV collapse activated charcoal may be effective for PO form naloxone can be used give slowly and only give enough to reverse resp depression... 

Urine alkalinization is a treatment modality that increases elimination of poisons by the intravenous administration of sodium bicarbonate to produce urine with a pH of more than or equal to 7.5 and must be supported by high urine flow. This technique might be useful for the elimination of drugs with an acid pKa such as salicylates (but not recommended for phenobarbital intoxication for which multiple-dose activated charcoal is better), chlorpropamide, 2,4-dichlorophenoyacetic acid, diflunisal, fluoride, mecoprop, methotrexate. Complications include severe alkalemia, hypokalemia, hypocalcemia and coronary vasoconstriction. 

General supportive care should be provided. Aggressive gut decontamination should be carried out using repeated doses of activated charcoal and whole bowel irrigation. Propranolol or other blockers (eg, esmolol) are useful antidotes for B-mediated hypotension and tachycardia. Phenobarbital is preferred over phenytoin for convulsions most anticonvulsants are ineffective. Hemodialysis is indicated for serum concentrations greater than 100 mg/L and for intractable seizures in patients with lower levels. 

Treatment of strychnine poisoning involves an oral administration of an activated charcoal which absorbs any unabsorbed poison within the digestive tract. Unabsorbed strychnine can be removed from the stomach by gastric lavage with tannic acid (strong tea) or potassium permanganate solutions to oxidize strychnine. Seizures are controlled by anticonvulsants, such as phenobarbital or diazepam, along... 

Activated charcoal Carbamazepine Lamotrigine Phenobarbital Phenytoin Valproate With some drugs can be exploited to reduce drug concentrations in overdose Sequestration in the gastrointestinal tract... 

A 10-year-old boy developed respiratory depression and became comatose after taking the Chinese patent medicine Diankexing for 6 months. His urine phenobarbital concentration was 95 pg/ml (target range 20-40 pg/ml). The remedy was withdrawn and he was successfully treated with activated charcoal. 

A 20-month-old girl developed status epilepticus after ingesting camphor and required ventilation. She was treated with intravenous diazepam and phenobarbital and nasogastric-activated charcoal and made a complete neurological recovery (3). 

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