Brand Name
Acta-Char
Liquid-A, Actidose-Aqua, Aqueous Charcodote [Canada], Charac-50 [Canada],
CharcoAid 2000, Charcodote [Canada], Insta-Char, Insta-Char Aqueous Suspension,
Liqui-Char, SuperChar Aqueous
Class and Category
Chemical class: Adsorbents
Therapeutic class: Antidotes
Pregnancy category: C
Indications and Dosages
Acute
management of many oral poisonings following emesis/lavage.
Antidote
• PO (Adults): 25–100 g (may be repeated q 4–6 hr)..
• PO (Children 1–12 yr): 25–50 g (may be repeated q 4–6 hr)..
• PO (Children <1 yr): 1 g/kg (may be repeated q 4–6 hr)..
Availability
• Powder: 15-, 25- 30-[canada], 40-, 120-, 125-g 240-gOTC containers
• Oral suspension: 12.5 g/60 mLOTC, 15 g/72 mLOTC, 15 g/120 mLOTC, 25 g/120 mLOTC, 30 g/120 mLOTC, 50 g/240 mLOTC, 15 g/120 mLOTC, 25 g/125 mLOTC, 50 g/225 mLOTC, 50 g/250 mLOTC
• In combination with: sorbitol (Actidose with Sorbitol), Charcoaid, Pediatric Charcodote[canada], Charac-tol[canada], (Charcodote TFS)OTC[canada]
Route Onset Peak Duration
PO within min Unknown 4–12
hr
Pharmacokinetics
Absorption: None.
Distribution: None.
Metabolism and Excretion: Excreted unchanged in the feces.
Half-life: Unknown.
Mechanism of Action
Binds drugs and chemicals in the GI tract.
Therapeutic Effect(s):
Decreased intestinal absorption of drugs or chemicals in the overdose situation.
Contraindication
No
known contraindications.
Use Cautiously in:
•
Poisonings due to cyanide, corrosives, ethanol, methanol, petroleum
distillates, organic solvents, mineral acids, or iron;
•
Endoscopic examination (observation will be obscured).
Drug Interactions
DRUG
Other
drugs including ipecac syrup and laxatives will be adsorbed by charcoal and as
a result will not be systemically absorbed from the GI tract.
FOOD
Milk,
ice cream, or sherbet will decrease the ability of charcoal to absorb other
agents.
Adverse Reactions
GI: black stools, constipation, diarrhea, vomiting.
Nursing Consideration
Assessment
•
Assess neurologic status; administer only if patient is alert (unless airway is
protected).
•
Inquire as to the type of drug or poison and time of ingestion.
•
Consult reference, poison control center, or physician for symptoms of toxicity
of ingested agent(s).
•
Monitor BP, pulse, respiratory and neurologic status, and urine output as
indicated by toxicity of agent(s). Notify physician if symptoms persist or
worsen.
Lab
Test Considerations
•
Chronic use may impair absorption of essential nutrients. This may result in
decreased mineral or electrolyte levels.
Potential Nursing Diagnoses
•
Risk for self-directed violence (Indications)
•
Risk for injury (Indications)
Implementation
•
Treatment of Poisoning: Activated charcoal is most effective if administered
within 30 min of ingestion of drug or poison. Dosage may be repeated for drugs
subjected to enterohepatic elimination to minimize further absorption.
»
If syrup of ipecac is used, administer ipecac first and wait until emesis
occurs before administering activated charcoal.
•
PO: Mix dose in 6–8 oz water; administer as a slurry (unless using suspension
with or without sorbitol). Do not administer with milk products (milk, ice
cream, or sherbet). May need to be diluted with additional water to be thin
enough to administer through a nasogastric tube.
»
Shake oral suspension well before administration.
»
Rapid ingestion may cause vomiting. If vomiting occurs shortly after
administering dose, confer with physician about repeating dose.
»
Do not administer other oral drugs for 2 hr before or after administering
activated charcoal.
»
Slurry is constipating; physician may order a laxative to speed removal of the
drug. May not be required with products containing sorbitol.
Patient/Family
Teaching
•
Inform patient that stools will turn black.
•
Poisoning: When counseling, discuss methods of prevention, need to confer with
poison control center, physician, or emergency department before administering,
and need to bring ingested substance to emergency department for
identification.
Evaluation/Desired
Outcomes
Prevention
or resolution of toxic effects of ingested agent.
