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Does multiple-dose charcoal therapy enhance salicylate excretion?

Article Abstract:

Activated charcoal is a commonly used agent for treating acute drug overdose or accidental poisoning. The charcoal acts as a nonspecific adsorbent, meaning the drug or poison simply sticks to the particles of charcoal and is therefore unavailable for absorption into the bloodstream. Charcoal apparently functions in another way, as well. Some drugs, such as phenobarbital and theophylline, can freely pass both ways across the lining of the stomach and intestine (to and from the bloodstream). Without any treatment, equilibrium is soon reached, and the amount of drug moving from the intestines into the bloodstream is equal to the amount passing in the opposite direction. However, if repetitive doses of charcoal are given, the drug leaving the blood for the digestive tract can be bound up and prevented from re-entering the circulation. Therefore, the charcoal can be effective in removing not only drugs which are in the digestive tract, but those which have already entered the circulation as well. Ten volunteers agreed to test whether this method could be used to increase the elimination of aspirin from the body, a substance quite commonly taken in excessive doses. The volunteers consumed 2,880 milligrams of aspirin, the equivalent of eight or nine regular tablets. The subjects were then given 25 grams of activated charcoal 4, 6, 8, and 10 hours after taking the aspirin. The results indicate that the treatment was statistically significant. However, with the apparent reduction of blood aspirin level of only 9 percent, it seems that the multiple-dose charcoal therapy is unlikely to be of clinical importance in the treatment of aspirin overdose. (Consumer Summary produced by Reliance Medical Information, Inc.)

Author: Kirshenbaum, Lorrie A., Mathews, Susan C., Sitar, Daniel S., Tenebein, Milton
Publisher: American Medical Association
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
Health aspects, Poisoning, Accidental, Accidental poisoning, Aspirin, Activated carbon, Carbon, Activated, Charcoal

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Refractory potassium repletion due to cisplatin-induced magnesium depletion

Article Abstract:

Cisplatin is an anticancer drug that has been found to reduce levels of magnesium and potassium in patients treated by chemotherapy by increasing kidney secretion of these ions. The loss of appetite that is associated with anticancer chemotherapy can further reduce the level of these ions because of low food intake. Two cases of severe magnesium and potassium depletion in cisplatin-treated patients are reported, and physicians are reminded of the necessity to routinely assess cisplatin-treated patients for magnesium and potassium levels. The depletion of potassium is often resistant to treatment in the absence of adequate magnesium. When such resistance is seen, as in the two patients reported, levels of magnesium should be investigated.

Author: Rodriguez, Mariano, Solanki, Dilip L., Whang, Robert
Publisher: American Medical Association
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1989
Abnormalities, Complications and side effects, Antineoplastic agents, Cisplatin, Magnesium in the body, Magnesium (Nutrient), Potassium in the body, Potassium (Nutrient), Hypokalemia

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Subjects list: Care and treatment
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