Charcoal, Activated
Kelas obat: Agen Antineoplastik
Panganggone Charcoal, Activated
Keracunan
Bisa digunakake kanggo perawatan (dekontaminasi GI) ing umume keracunan lisan kajaba sing nglibatake agen korosif (contone, asam kuat utawa alkali) utawa zat sing kapasitas nyerep kurang banget kanggo klinis. migunani (contone, uyah wesi, litium, asam borat, arsenik, malathion, utawa pelarut organik kayata metanol, etanol, utawa etilena glikol).
Agen sing paling umum digunakake kanggo dekontaminasi GI ing pasien sing keracunan; Nanging, administrasi rutin ing pasien keracunan ora dianjurake dening American Academy of Clinical Toxicology lan European Association of Poisons Centers and Clinical Toxicologists (AACT/EAPCCT). Pasinaon sing dikontrol nuduhake nyuda morbiditas lan mortalitas umume kurang. (Deleng Umum: Keracunan, miturut Dosis lan Administrasi.)
Hemoperfusi
Hemoperfusi liwat kolom arang aktif kanggo mbusak racun endogen utawa eksogen ing uremia, gagal hepatik, utawa keracunan akut sing ana gandhengane karo overdosis obat tartamtu.
Gangguan GI
Adsorpsi gas usus ing perawatan kembung, distensi usus, lan dyspepsia; FDA diklasifikasikake minangka kurang bukti khasiat minangka antiflatulen utawa bantuan pencernaan.
Wis digunakake piyambak utawa digabungake karo kaolin ing perawatan diare, nanging regane durung ditetepake.
Tatu lan Ulser
Wis digunakake ing dressings kanggo suppurating tatu utawa ulcers kanggo ngurangi ambu ora enak lan ningkatake penyembuhan.
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Carane nggunakake Charcoal, Activated
Umum
Keracunan
Administrasi
Administrasi Lisan
Administrasi bubuk areng aktif kanthi lisan utawa liwat tabung nasogastrik utawa orogastrik minangka slurry utawa suspensi sing disiapake sacara ekstemporer utawa suspensi sing kasedhiya kanthi komersial.
Infus nasogastrik sing terus-terusan utawa divisi saka total dosis menyang jumlah sing luwih cilik sing diwenehake luwih kerep bisa nambah toleransi dosis gedhe.
Yen antiemetik dibutuhake kanggo kasil ngatur dosis dhuwur, jinis serotonin 3 (5-HT3) antagonis reseptor (contone, ondansetron) utawa metoclopramide bisa uga luwih disenengi.
Sorbitol bisa diwenehake karo arang aktif dosis siji utawa kanthi dosis kaping pisanan saka regimen dosis kaping pindho kanggo rasa enak lan tumindak laxative. ; suspending tambahan lan agen flavoring umume ora dianjurake.
RekonstitusiExtemporaneously, nyampur wêdakakêna karo banyu ketok sing cukup (contone, 20-30 g ing paling 240 mL) kanggo mbentuk slurry.
Dosis
Pediatrik Pasien
Keracunan Regimen Dosis Tunggal utawa Multiple Dosis Oral kanggo Perawatan Keracunan ing AnakUmur
Dosis Tunggal
Pulang Dosis
Bayi nganti umur 1 taun
10–25 g utawa 0,5–1 g/kg
Bocah nganti umur 13 taun
25–50 g utawa 0,5–1 g/kg
10–25 g wiwitane, banjur 1–2 g/kg saben 2 –4 jam
Remaja ≥13 taun
25–100 g
50–100 g wiwitane, banjur 12,5 g saben jam, 25 g saben 2 jam, utawa 50 g saben 4 jam
Dewasa
Keracunan OralDosis tunggal: 25–100 g utawa 0,5–1 g / kg; kanggo ingestion massal saka zat sing beracun utawa yen adsorpsi winates saka zat sing bisa nyebabake bisa menehi manfaat klinis sing substansial, 1,5-2 g / kg bisa diwenehi.
Pilihan dosis: 50-100 g, banjur 12,5 g saben jam, 25 g saben 2 jam, utawa 50 g saben 4 jam. Utawa, 0,5-1 g / kg saben 4-6 jam kanggo ingestion kanthi resiko sing luwih murah lan dosis sing luwih gedhe (contone, 1-1,5 g / kg saben jam) kanggo ingestion sing luwih serius (contone, ingestion teofilin dilepasake sing ngancam nyawa) . Terusake terapi dosis kaping pirang-pirang nganti pasien pulih utawa keracunan utama rampung.
Gangguan GI Oral0,6–5 g minangka dosis tunggal utawa 0,975–3,9 g 3 kali dina sawise mangan.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Distillates Petroleum Ingestion
Aja digunakake kanggo ingestion saka distillates petroleum (contone, bensin, kerosene); khasiat winates, lan keracunan saliyane aspirasi arang banget.
Sorbitol lan CatharticsSorbitol, sing ana ing pirang-pirang preparat komersial, kudu diwenehake mung kanthi dosis siji areng aktif utawa dosis pisanan saka areng aktif kaping pindho; ora luwih saka 1 utawa 2 dosis sorbitol utawa katartik liyane (yen dibutuhake) kudu digunakake sajrone 24 jam amarga potensial kanggo dehidrasi, hipotensi, gangguan elektrolit (umpamane, hipernatremia) sing ana gandhengane karo katarsis sing berlebihan.
Yen sorbitol digunakake kanthi dosis awal arang aktif, katartik kapindho umume ora bisa diwenehake.
Gunakake sorbitol kanthi ati-ati ing bocah-bocah lan pasien geriatri; monitor hidrasi lan elektrolit.
Pancegahan Umum
Efek GIBisa nyebabake muntah, konstipasi, diare, lan alangan GI utawa impaksi fecal ing pasien dehidrasi.
Umumé ora bisa digunakake nalika ana peristalsis suda (suda utawa ora ana swara usus); yen ana risiko obstruksi GI, perforasi, utawa pendarahan; yen operasi wis kedadeyan bubar; utawa yen ora imbangan elektrolit utawa kurang volume ana.
Efek ParuAspirasi saka arang aktif bisa nyebabake komplikasi sing luwih abot tinimbang aspirasi isi lambung mung. Aspirasi saka muntah utawa kateter nasogastrik sing salah wis nyebabake reaksi granulomatous, bronchiolitis obliterans, reaksi jaringan kanggo agen suspensi (sorbitol, povidone), tambah permeabilitas paru-paru, lan arang banget mati.
Njupuk langkah-langkah kanggo nyuda resiko aspirasi (contone, penempatan tabung endotrakeal sing dicuffed ing pasien sing duwe gangguan refleks laring).
Panganggone Kombinasi TetepYen digunakake ing kombinasi tetep karo agen liyane, nimbang ati-ati, pancegahan, lan kontraindikasi sing digandhengake karo agen bebarengan.
Efek Umum sing Sabar
Muntah, diare, konstipasi, feces ireng.
Apa obatan liyane bakal mengaruhi Charcoal, Activated
Bisa nyuda panyerepan lan respon terapeutik kanggo obat-obatan liyane sing diwenehake kanthi lisan. Obat-obatan liyane saka sing digunakake kanggo dekontaminasi GI utawa antidotes kanggo racun sing dicerna ora kudu diwenehake sajrone 2 jam saka areng aktif; yen perlu, terapi obat bebarengan bisa diwenehi parenteral.
Obat Spesifik
Obat
Interaksi
Komentar
Acetylcysteine, oral
Adsorpsi acetylcysteine in vitro; ora ana penurunan sing signifikan ing khasiat sing katon ing studi manungsa
Sirup Ipecac
Emesis sing disebabake dening Ipecac bisa ngganggu khasiat adsorptif saka areng aktif; nyuda emesis karo ipecac ora mungkin
Ipecac umume ora dianjurake; yen ipecac wis digunakake kanggo ngindhuksi emesis, gunakake areng aktif sawise muntah mandheg
Solusi polietilen glikol lan elektrolit
Potensi penurunan kapasitas adsorpsi arang aktif
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