Basic Approaches to Treatment III (20) - End E2 Flashcards
What is activated charcoal?
organic matter - first burned then oxidized to increase number of pores
- huge number of pores!
What does activated charcoal’s efficacy depend on?
- time after ingestion of toxin
- how long it stays in the GI tract
- toxin to ACT ratio
- stomach contents
- quality of AC product
What is ToxiBan?
kaolin - cathartic, protects against mucosa/GI tract
What is sorbitol?
a cathartic - a substance that accelerates bowel movements (osmotic in this case)
When do you give activated charcoal?
the sooner the better!
best results if given within 30 minutes of toxin ingestion
What is the MOA for AC?
enhances elimination by decreasing enterohepatic recycling
If you give AC before emesis or lavage, what are the characteristics?
- starts binding the toxin right away
- increases contents in the stomach, improves emesis
- CAN’T USE VOMIT
- must repeat after emesis or lavage is complete
If you give AC after emesis or lavage, what are the characteristics?
- less toxin to bind up all available sites on AC
- vomit or lavage fluid can be used for analysis
What may be way more common than we think with activated charcoal?
hypernatremia
previously thought was due to cathartic in AC mixture
- now know can be associated with AC alone
What are adsorbing agents other than AC?
What is the goal of using activated charcoal and other things like it?
to remove as rapidly as possible any toxin that has already been absorbed into the systemic circulation and tissues
to diminish degree and duration of toxic effects
What are the major methods for elimination?
In some cases, the goal is to decrease conversion of a ______
less-toxic substance to a more toxic metabolite
What is the intravenous lipid emulsion treatment?
uses products designed for partnered nutrition
lipid-soluble compounds in blood extracted by lipid emulsion
What are less common methods of enhancing elimination?