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The effect of activated charcoal on phenytoin pharmacokinetics
A M Rowden1, J E Spoor, J S Bertino
1Department of Pharmacy Services, Mary Imogene Bassett Hospital, Cooperstown, New York 13326.
Study Objectives:
To examine the effect of administration of oral activated charcoal with or without sorbitol on the elimination of phenytoin.
Setting:
Emergency department of a rural teaching institution.
Type Of Participants:
Eight normal volunteers.
Interventions:
Subjects received 15 mg/kg phenytoin as an IV infusion. During the first phase of the study, oral activated charcoal was administered to a total dose of 140 g over a ten-hour period. During the second phase of the study, phenytoin alone was administered.
Measurements And Main Results:
Administration of activated charcoal resulted in a significant decrease in the area under the curve 0-inf (p = .008) and in total body clearance (P = .008). No difference in the effect on phenytoin pharmacokinetic parameters was noted when the charcoal was administered with or without sorbitol, but fewer gastrointestinal adverse effects were noted without sorbitol treatment.
Conclusion:
Oral activated charcoal was shown to affect phenytoin pharmacokinetic parameters. Further pharmacokinetic/pharmacodynamic studies are warranted to determine if activated charcoal results in a faster recovery from phenytoin toxicity.