Pediatric Carbamazepine Toxicity Medication
- Author: Muhammad Waseem, MD, MS; Chief Editor: Timothy E Corden, MD more...
Consider activated charcoal decontamination in any patient who presents within 4 hours of ingestion, or even later if the patient has an overdose with a sustained release preparation or has evidence of significant toxicity.
Emergency treatment in poisoning caused by drugs and chemicals. Network of pores present in activated charcoal absorbs 100-1000 mg of drug per gram of charcoal. Prevents absorption by adsorbing drug in the intestine. Multidose charcoal may interrupt enterohepatic recirculation and enhance elimination by enterocapillary exsorption. Theoretically, by constantly bathing the GI tract with charcoal, the intestinal lumen serves as a dialysis membrane for reverse absorption of drug from intestinal villous capillary blood into intestine. Does not dissolve in water.
For maximum effect, administer within 30 min after poison ingestion. The usual dose is 1 g/kg but never less than 30 g. It can be repeated in a dose of 0.5 g/kg q2h or 1 g/kg q4h when indicated, until the patient is asymptomatic and/or toxic drug levels have decreased to safe levels if measurable.
Sorbitol may be added to activated charcoal to improve its palatability. However, as mentioned above, it should never be used with multiple doses of charcoal, and never in children younger than 1 y.
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