The use of activated carbon in poisoning
Activated carbon is a drug belonging to the group of sorbents. One of the areas of its application is the treatment of poisoning by neutralizing toxins in the digestive tract and in the blood. Details ahead.
Physico-chemical properties of activated carbon
- Activated carbon is insoluble in water and other solvents, has no taste and smell.
- Its base is represented by a porous structure. The pore size is proportional to the absorption capacity of the drug. Since the reaction takes place on the surface of a substance, and due to the pores, this area is larger compared to a flat surface.
- Adsorbing property - is measured using an iodine index, which is calculated by the amount of iodine adsorbed on the surface of activated carbon.
- Resistance to external influences.
- The dependence of the rate of adsorption on the size of the granules of the substance.
- Available in pill and powder form.
The use of activated carbon in poisoning
Activated carbon is a multifunctional antidote. The essence of the action of coal in case of poisoning lies in its obstacle to the absorption of toxic substances from the gastrointestinal tract and, thus, their neutralization. He also has the ability to reduce diarrhea syndrome. It is also used in hemosorption to remove toxins from the blood.
Since activated carbon does not have an action selectivity, the neutralization of poison in the blood is non-specific (non-selective hemosorption).
The use of coal at different stages of assistance
There is a general algorithm for the treatment of poisoning. Coal sorbent is used in the first stage, when it is necessary to prevent the absorption of poison that has entered the stomach, which it does. In this regard, it is convenient to use, since it can be given at the pre-medical stage of care.
In the future, during treatment in the hospital, it is used in hemosorption, as has already been said.
In case of intoxication resulting from exposure of the poisonous substance to the respiratory tract or directly into the blood bypassing the gastrointestinal tract (for example, overdose with intravenous drugs), the drug is not effective at the initial stage of care, since it is not absorbed in the digestive system.
It is important to remember that activated carbon in case of poisoning by acids, alkalis, alcohol and its surrogates is less effective.
The influence of some factors on the effect of activated carbon
The effect of activated carbon in food poisoning depends on the amount of contents in the stomach at the time of taking the medicine. If the stomach was full, the dose should be higher.
The drug, while reducing its concentration in the digestive system, is capable of desorption, that is, releasing the captured “captive” back, so it is important to take it several times a day.
Features of the use of activated carbon
- Sometimes use the addition of coal when washing the stomach.
- It should be noted that the use of activated carbon with vomiting, which is indomitable, does not make sense until the arrival of doctors. Since the patient simply can not swallow it.
- An ambulance team that arrives can wash the stomach and inject the drug through a probe with vomiting in dosages up to 15 g. If recalculated to tablets, you get 2 tablets of 500 mg per kg per day. Thus, for a person weighing 70 kg in case of poisoning, 140 tablets are prescribed per day, if divided into 4 doses, about 30 tablets are obtained for 1 time.
- In the future, the reception of activated carbon in case of poisoning is repeated 3-4 times a day, for several days. The duration of the appointment is determined by the doctor in each case. This is due to the fact that partly can re-enter the digestive tract with bile. Thus, it usually occurs in case of poisoning with drugs (for example, hypnotics or cardiac glycosides), which, when they enter the blood, bind to proteins and can circulate in the body for a long time, creating the so-called cumulation effect. This is the ability of the drug to accumulate in the blood.
Statistics show that the average appeal for medical care in case of poisoning occurs after a few hours or even days. Therefore, there is an opinion that if a long time has passed after the poisoning, then there is no sense in taking activated carbon. This opinion refutes the study, during which an analysis of the gastric contents of people who died from poisoning was carried out. In all cases, the presence of a poisonous substance in the digestive tract of the victims was confirmed 2–3 days after the ingestion of the toxic substance. The reason for this fact is the ability to cumulate some poisons, the mechanism of which has already been said.
The use of activated carbon during pregnancy
Is it possible for pregnant women activated carbon in case of poisoning?
The drug does not have a negative effect on the fetus, therefore, in the absence of an allergic reaction to coal, it is used during pregnancy.
- The use of activated carbon in poisoning is unacceptable if there is an allergic reaction to the drug. In this case, it is replaced by an analogue.
- Peptic ulcer disease is also a contraindication. Apparently, this is due to the possibility of coal to provoke an exacerbation of the disease.
- When bleeding from the gastrointestinal tract - as the drug can "hide" the true state of affairs and the doctor during the examination of such a patient has the risk of missing a risk.
It is believed that any coal is good in cases of poisoning, and some replace activated carbon with white. Let us examine this question.
White coal is produced on the basis of silicon dioxide, which has good sorption capacity and microcrystalline cellulose. The latter improves digestion, intestinal peristalsis. The drug has a number of useful properties.
It is soluble in water, so it is more convenient when washing the stomach and has an adsorption capacity of 2-2.5 times higher than activated charcoal. Accordingly, the dose required for the disposal of toxins will be 2-2.5 times less and, unlike activated carbon, it does not cause constipation.
Contraindications are the same plus white coal for poisoning is not recommended for pregnant women and during lactation.
The average daily dose of a commercial analogue of white coal is Polysorb MP, for adults it is 6–12 teaspoons of powder with a slide, the maximum is 20 spoons with a slide.
However, in modern algorithms for providing emergency aid for 2013 there is no indication of white coal. And, more precisely, in the first place continues to remain activated carbon, in the second - all other sorbents.
Activated carbon is an essential component of a first-aid kit and is a proven remedy for poisoning.