Natren Probiotics

How Activated Charcoal Works

How Activated Charcoal Works

Activated charcoal exerts its effects by absorbing a wide variety of drugs and chemicals. Adsorption is a process in which atoms and molecules move from a bulk phase (such as a solid, liquid, or gas) onto a solid or liquid surface. In other words, the toxic substance attaches to the surface of the charcoal. Because charcoal is not "digested," it stays inside the GI tract and eliminates the toxin when the person has a bowel movement.
  • This mechanism of action should not be confused with absorption. Absorption occurs when a substance passes into or through a tissue, like water passing into a sponge. Once the chemical or drug has been absorbed by the GI tract, activated charcoal can no longer retrieve the toxic ingestion. It will only attach to substances that are still inside the stomach or intestines.

  • The charcoal is "activated" because it is produced to have a very fine particle size. This increases the overall surface area and adsorptive capacity of the charcoal. It is produced by adding acid and steam to carbonaceous materials such as wood, coal, rye starch, or coconut shells. To put this in perspective, one standard 50-gram dose of activated charcoal has the surface area of 10 football fields.

  • Activated charcoal is often combined with sorbitol (a substance that stimulates the bowels to move, like a laxative) to shorten the amount of time to move through the system and reduce the possibility of constipation. However, to avoid adverse effects, sorbitol is not given with every dose of activated charcoal.

  • All efforts should be made to reduce adsorption of severely toxic substances, as activated charcoal  does not bind as well with these substances:

    • Lithium (Eskalith, Lithobid), strong acids and bases, metals and inorganic minerals such as sodium, iron, lead, arsenic, iodine, fluorine, and boric acid.

    • Alcohol (such as ethanol, methanol, isopropyl alcohol, glycols, and acetone)

    • Hydrocarbons (such as petroleum distillates and plant hydrocarbons such as pine oil)

  • Activated charcoal does not irritate the mucous membranes of the GI system. In addition to adsorption of toxins, activated charcoal also adsorbs food nutrients, vitamins, and minerals. However, this short-term effect is not a concern when activated charcoal is used to treat poisoning.

How Activated Charcoal Is Given

Activated charcoal may be given by mouth to someone who is awake and alert. It is a black liquid drink.

  • If the person vomits the drink, another dose will be given through a nasogastric or orogastric tube (a tube inserted through the nose or mouth, down the esophagus and into the stomach).

  • If the person is unconscious (or nearly so), an endotracheal intubation (a procedure in which a tube is inserted through the mouth down into the trachea) may be necessary. This will allow oxygen to be delivered and will help protect the airway and lungs from gastric content. This will minimize the risk of the person vomiting and choking.

  •  In the United States, the direct line to the poison control center is 1-800-222-1222.

  • The doctor also determines when and if additional doses are given by monitoring blood levels of the poison. Other symptoms the doctor monitors are nausea and vomiting, abdominal pain, dizziness, and severe heart problems. Multiple doses of activated charcoal can be given if someone swallowed large doses of long-acting, sustained release medications.

  • If blood levels of the poison remain too high, the doctor may recommend kidney dialysis. Dialysis is the best way to remove the toxin from the bloodstream.

When Not to Use Activated Charcoal

  • Activated charcoal will not be given to people with an obstruction of the intestines or if the person swallowed a corrosive agent, such as a strong acid or alkali.

  • Strong acids may "burn" through the lining of the GI tract. Doctors will need to look at the lining with an endoscope - a special instrument designed to look inside the stomach. Activated charcoal is not to be used with this type of poison because it is difficult to see the lining of the GI tract with the scope after charcoal is given.

  • Activated charcoal can cause intestinal problems such as constipation, or it can create clumps of foreign material. This situation can be prevented by giving a laxative such as sorbitol to the patient, however, repeated doses with sorbitol may cause excessive diarrhea, dehydration, and chemical imbalance.

  • If the patient is fructose intolerant, family members should notify the treating doctor, and sorbitol will not be given with the activated charcoal. Sorbitol is a sugar substitute that acts as a laxative to move the charcoal through the system. Babies younger than one year of age year should not be given sorbitol because it may cause excessive fluid losses.

  • If an antidote to a specific type of drug poisoning is given, then the doctor may not give activated charcoal because the drug given as treatment will also be adsorbed. A classic example is an acetaminophen (Tylenol overdose), in which there is a clearly established antidote with acetylcysteine (Mucomyst).
 In the United States, the direct line to the poison control center is 1-800-222-1222.

Disclaimer: The entire contents of this website are based upon the opinions of I'm Holistic, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experiences of I'm Holistic. I'm Holistic encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

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