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Related Concept Videos

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration01:25

Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration

Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
Pharmaceutical Poisoning: Treatment Strategies01:26

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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
Prevention of Further Absorption of Poison01:14

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In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
Enhanced Elimination of Poison01:26

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...

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Updated: May 23, 2026

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
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Charcoal haemoperfusion for paracetamol overdose.

B G Gazzard1, R A Willison, M J Weston

  • 1The Liver Unit, King's College Hospital and Medical School, Denmark Hill, London.

British Journal of Clinical Pharmacology
|March 29, 2012
PubMed
Summary

Early charcoal haemoperfusion for paracetamol overdose offers no clinical benefit. This treatment showed limited paracetamol removal and variable plasma clearance, failing to improve patient outcomes in this controlled trial.

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Area of Science:

  • Toxicology
  • Nephrology
  • Critical Care Medicine

Background:

  • Paracetamol (acetaminophen) overdose is a common clinical problem.
  • Early intervention is crucial to prevent hepatotoxicity.
  • Charcoal haemoperfusion has been explored as a method to enhance paracetamol clearance.

Purpose of the Study:

  • To evaluate the efficacy of early charcoal haemoperfusion in treating paracetamol overdose.
  • To assess the effectiveness of charcoal haemoperfusion in removing paracetamol from plasma.

Main Methods:

  • A controlled trial was conducted involving patients with paracetamol overdose.
  • Charcoal haemoperfusion was administered as an early treatment.
  • Plasma clearance and cumulative amounts of paracetamol removed were measured.

Main Results:

  • Charcoal haemoperfusion showed no significant clinical benefit in paracetamol overdose.
  • Plasma clearance rates were variable and generally low (4-119 ml/minute).
  • Mean paracetamol removal was low (1.4 g), with minimal impact on overall drug levels.

Conclusions:

  • Early charcoal haemoperfusion is not an effective treatment for paracetamol overdose.
  • The technique demonstrated limited efficacy in clearing paracetamol from the bloodstream.
  • While the procedure was safe, it did not provide a clinical advantage.