The use of activated carbon in poisoning
Activated carbon is a drug belonging to a group of sorbents. One of the areas of its application is the treatment of poisonings 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 absorbent capacity of the drug. Since the reaction occurs on the surface of the substance, and due to the pores, this area is larger in comparison with an even surface.
- The adsorbent property is measured by the iodine index, which is calculated by the amount of iodine adsorbed on the surface of the activated carbon.
- Resistance to external influences.
- Dependence of the adsorption rate on the size of the substance granules.
- Produced in the form of tablets and powder.
The use of activated carbon in poisoning
Activated carbon is a multifunctional antidote. The essence of the action of coal in poisoning lies in its obstruction of the absorption of toxic substances from the gastrointestinal tract and, thus, their neutralization. He also has the ability to reduce diarrheal syndrome. It is also used in hemosorption to remove toxins from the blood.
Since activated carbon does not have a selective effect, the neutralization of the poison in the blood is nonspecific (nonselective hemosorption).
The use of coal at various stages of assistance
There is a general algorithm for treating poisoning. Coal sorbent is used in the first stage, when it is necessary to prevent the absorption of poison that has got into the stomach, which it does. In this regard, it is convenient to use, since it can be started at the pre-hospital stage of care.
Later, when treated in a hospital, it is used in hemosorption, which has already been said.
In cases of intoxication caused by the ingress of a poison into the respiratory tract or directly into the blood bypassing the gastrointestinal tract (for example, with an overdose of intravenous drugs), the drug is not effective at the initial stage of care, as it is not absorbed in the digestive system.
It is important to remember that activated charcoal in poisoning with acids, alkalis, alcohol and its surrogates is less effective.
The influence of certain 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, then the dose should be higher.
The drug with a decrease in its concentration in the digestive system is capable of desorption, that is, back to release the captured "captive", so it is important to administer several times a day.
Features of the use of activated carbon
- Sometimes the use of coal during gastric lavage is used.
- It should be noted that the use of activated carbon in vomiting, which is indomitable, does not make sense before the arrival of doctors. Since the patient simply can not swallow it.
- The arrived ambulance team can perform gastric lavage and insert the drug through the probe when vomiting at a dosage of up to 15 g. If you count on tablets, you get 2 tablets of 500 mg per 1 kg per day. Thus, for a person weighing 70 kg when poisoning is prescribed 140 tablets per day, if divided into 4 receptions, about 30 tablets are obtained by 1 time.
- In the future, the reception of activated carbon during 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 part of the cassava can again enter the digestive tract with bile. So, usually occurs with poisoning with drugs (for example, hypnotics or cardiac glycosides) that get into the blood, bind to proteins and can long circulate in the body, creating a so-called cumulation effect. This is the ability of the medicine to accumulate in the blood.
Statistics show that the average request for medical care for poisoning occurs in a few hours or even days. Therefore, there is an opinion that if after a poisoning a lot of time has passed, then activated charcoal does not make sense. This opinion is refuted by the study, during which the 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 affected was confirmed 2-3 days after the toxic substance had entered. 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 in pregnancy
Is it possible for pregnant women to have activated charcoal during poisoning?
The drug does not have a negative effect on the fetus, so in the absence of an allergic reaction to charcoal it is used during pregnancy.
Contraindications for use
- The use of activated charcoal in poisoning is unacceptable if there is an allergic reaction to the drug. In this case, it is replaced by an analog.
- Peptic ulcer is also a contraindication. Apparently, this is due to the possibility of coal provoking an exacerbation of the disease.
- When bleeding from the gastrointestinal tract - since the drug can "hide" the true state of affairs and the doctor in the examination of such a patient has the risk of missing the danger.
There is an opinion that any coal is good for poisoning, and some replace activated charcoal with white. We will analyze this question.
White coal is produced on the basis of silicon dioxide, which has a good sorption ability 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 that of activated charcoal. Accordingly, the dose necessary for neutralizing 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 and lactating.
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 of emergency care for 2013 there is no indication of white coal. And, more precisely, in the first place is still activated charcoal, on the second - all other sorbents.
Activated charcoal is an obligatory component of the home medicine chest and is a proven means for poisoning.