 Activated charcoal itself is a fine, black
powder that is odorless, tasteless, and
nontoxic.
 It works by binding (adsorbing) chemicals,
thus reducing their toxicity (poisonous
nature), through the GI tract.
 It helps prevent the poison from being
absorbed from the stomach into the body.

 It is most effective when given within one hour
after toxin ingestion .
 It is the most effective decontaminant.
 Bind substances excreted in the bile,
interrupting enterohepatic circulation.
The benefits are capable
 to decontaminate the gut without requiring
invasive procedures,
 its rapid administration and its proven safety
in both adults and children.

 Mnemonic: These People Drink Charcoal
Quickly
 Theophylline
 Phenobarbital
 Dapsone
 Carbamazepine
 Quinine
Others:
 OPC poisoning, Multi drug overdose.

 Activated charcoal is given through mouth or
nasogastric tube, in an activated charcoal drug
dose of 10:1 or
 Dose 1 - 2 gm/kg
 1-12 yrs -25-50 gm
 Older than 12 yrs- 25-100 gm
 Sorbitol and magnesium citrate are the most
commonly used cathartics. But they are no
longer recommended in poisonings.

 The substance that does not adsorbed by
activated charcoal .
 Mnemonic:CHARCOAL
 C-Caustics and corrosives
 H-Heavy metals
 A-Alcohol and glycols
 R-Rapidly absorbed substances
 C-Cyanide,chlorine
 O-Other insoluble drugs
 A-Aliphatic hydrocarbons
 L-Laxatives

Others:
 Absent Bowel sound
 Signs of intestinal obstruction
 Oesophageal or gastric perforation

 Constipation
 Diarrhoea
 Vomiting
Pulmonary aspiration is a dreaded complication
that results in
 pneumonitis
 obstruction in the respiratory tract
 barotrauma
 acute lung injury
 Even in intubated patients ,aspiration pneumonia
have occurred with instillation of activated
charcoal.

 Ingestion of large doses.
Purposes:
 Prevent continued absorption of a drug that may
still present in GI tract.
 Increase serum clearance of a drug.
 After an initial dose of 50–100 g to an adult,
activated charcoal should be administered
 at a rate of not less than 12.5 g/h or equivalent.
 Lower doses (10–25 g) of activated
charcoal may be employed in children less than 5
years of age as usually they have ingested smaller
overdoses and their gut lumen capacity is smaller

 The Universal Antidote is a mixture
that contains activated charcoal, magnesium
oxide, and tannic acid. All three components
neutralize the actions of many poisons.