Activated Charcoal
ACTIVATED CHARCOAL
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Introduction
· Activated charcoal is
a fine, odorless, black powder commonly used in emergency medicine to treat
certain types of poisoning.
· It's known for its
ability to adsorb (not absorb) toxins and chemicals, preventing their
absorption into the bloodstream from the stomach.
Definition
· Activated charcoal is
a form of carbon processed to have small, low-volume pores that increase the
surface area available for adsorption or chemical reactions.
· It is derived from
materials such as wood, coal, or coconut shells that are heated to high
temperatures in the presence of a gas that causes the charcoal to develop
internal pores.
Classification
Activated charcoal is classified based
on its source and the method of activation:
1.
Physical Activated Charcoal: Created through
physical activation using gases like steam or air.
2.
Chemical Activated Charcoal: Produced by
treating carbon-rich materials with chemicals like phosphoric acid or zinc
chloride.
Pharmacokinetics
·
Absorption: Activated charcoal is not absorbed
into the bloodstream; it works locally in the gastrointestinal (GI) tract.
·
Distribution: As it is not absorbed, it remains
within the GI tract.
·
Metabolism: Activated charcoal is not metabolized
by the body.
·
Excretion: It is excreted in the feces along
with the adsorbed toxins or drugs.
Mechanism of Action
· Activated charcoal
works by adsorbing toxins and chemicals onto its surface, preventing them from
being absorbed into the bloodstream from the gastrointestinal tract.
· This process
effectively reduces the bioavailability of the toxin or drug, minimizing its
potential harmful effects.
Uses
·
Poisoning and Overdose: It is most commonly
used in cases of drug overdose or poisoning to reduce the absorption of harmful
substances.
·
Digestive Health: Sometimes used to relieve bloating
and gas, though its efficacy in these uses is not well-supported by scientific
evidence.
·
Skin Care: Included in products for its
purported ability to draw out impurities and toxins from the skin.
Adverse Effects
·
Gastrointestinal Issues: Nausea, vomiting,
constipation, or diarrhea.
·
Aspiration Risk: If administered incorrectly,
especially in unconscious patients, there is a risk of aspiration leading to
respiratory complications.
·
Electrolyte Imbalance: Prolonged use can
lead to electrolyte imbalances.
Contraindications
·
Unprotected Airways: Patients who cannot
protect their airway (e.g., unconscious, semi-conscious) should not receive
activated charcoal orally due to the risk of aspiration.
·
Intestinal Obstruction or Perforation: In cases of
suspected or known intestinal blockage or perforation, activated charcoal is
contraindicated.
·
Ingestion of Corrosive Substances: Not recommended for
ingestion of corrosive agents like acids or alkalis, as it does not adsorb
these substances and can complicate visualization of burns during endoscopy.
Role of Nurse
·
Assessment: Assess the patient's condition and
the type of poisoning or overdose. Ensure that the patient can safely receive
activated charcoal.
·
Administration: Administer the activated charcoal
orally or via a nasogastric tube, ensuring the correct dosage and method of
administration to prevent complications like aspiration.
·
Monitoring: Closely monitor the patient for any
adverse effects, such as vomiting, respiratory distress, or changes in
consciousness.
·
Education: Educate the patient and their family
about the purpose of the treatment, potential side effects, and the importance
of follow-up care.
·
Documentation: Accurately document the
administration of activated charcoal, including the dose, time, and the
patient’s response to the treatment.
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