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Does multiple-dose charcoal therapy enhance salicylate excretion?
L A Kirshenbaum1, S C Mathews, D S Sitar
1Department of Pharmacology, University of Manitoba, Winnipeg, Canada.
Archives of Internal Medicine
|June 1, 1990
Summary
Multiple-dose activated charcoal therapy slightly increases salicylate excretion but offers modest clinical benefits for acute salicylate poisoning. Further controlled studies are needed to confirm its efficacy.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Medicine
Background:
- Multiple-dose activated charcoal therapy is known to enhance the elimination of certain drugs.
- The efficacy of this intervention in the postabsorptive phase for salicylate poisoning requires further investigation.
Purpose of the Study:
- To evaluate the effect of multiple-dose activated charcoal on salicylate excretion in the postabsorptive phase.
- To determine the clinical significance of this intervention for acute salicylate poisoning.
Main Methods:
- A randomized, controlled, crossover study involving ten human volunteers.
- Administration of 2880 mg aspirin followed by 25 g activated charcoal at 4, 6, 8, and 10 hours post-ingestion.
- Pharmacokinetic analysis based on serial serum salicylate levels and quantification of urinary salicylate excretion.
Main Results:
- Activated charcoal increased salicylate excretion by 9% and 18% in the experimental limb.
- These increases, while statistically significant, were deemed clinically modest.
Conclusions:
- Multiple-dose activated charcoal therapy provides a clinically modest benefit for acute salicylate poisoning.
- Controlled clinical data are necessary to validate its use as a standard intervention for salicylate overdose.