Skip to main content
Journal of Medical Toxicology logoLink to Journal of Medical Toxicology
. 2010 May 20;6(2):190–198. doi: 10.1007/s13181-010-0046-1

Activated Charcoal for Acute Poisoning: One Toxicologist’s Journey

Kent R Olson 1,
PMCID: PMC2919687  PMID: 20490748

Abstract

 

Keywords: Activated charcoal, Gastrointestinal decontamination, Poisoning, Drug overdose

Full Text

The Full Text of this article is available as a PDF (190.5 KB).

Acknowledgments

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Footnotes

Project not funded by any external sources

Not previously presented at any meeting

References

  • 1.Rumack BH. Emesis, charcoal and cathartics. JACEP. 1976;44(5):44. doi: 10.1016/s0361-1124(76)80168-2. [DOI] [PubMed] [Google Scholar]
  • 2.Chin L, Picchioni AL, Gillespie T. Saline cathartics and saline cathartics plus activated charcoal as antidotal treatments. Clin Toxicol. 1981;18(7):865–871. doi: 10.3109/15563658108990311. [DOI] [PubMed] [Google Scholar]
  • 3.Dresibach RH. Handbook of poisoning. 10. Los Altos: Lange Medical Publications; 1980. pp. 24–25. [Google Scholar]
  • 4.Riegel JM, Becker CE. Use of cathartics in toxic ingestions. Ann Emerg Med. 1981;10:254–258. doi: 10.1016/S0196-0644(81)80051-0. [DOI] [PubMed] [Google Scholar]
  • 5.Kulig K, Bar-Or DCantrill SV, Rosen P, Rumack BH. Management of acutely poisoned patients without gastric emptying. Ann Emerg Med. 1985;14:562–567. doi: 10.1016/S0196-0644(85)80780-0. [DOI] [PubMed] [Google Scholar]
  • 6.Albertson TE, Derlet RW, Foulke GE, Minguillon MC, Tharratt SR. Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. Ann Emerg Med. 1989;18:56–59. doi: 10.1016/S0196-0644(89)80314-2. [DOI] [PubMed] [Google Scholar]
  • 7.Pond SM, Lewis-Driver DJ, Williams GM, Green AC, Stevenson NW. Gastric emptying in acute overdose: a prospective randomized controlled trial. Med J Austr. 1995;163(7):345–349. doi: 10.5694/j.1326-5377.1995.tb124625.x. [DOI] [PubMed] [Google Scholar]
  • 8.Merigian KS, Woodard M, Hedges JR, Roberts JR, Stuebing R, Rashkin MC. Prospective evaluation of gastric emptying in the self-poisoned patient. Am J Emerg Med. 1990;8:479–483. doi: 10.1016/0735-6757(90)90146-Q. [DOI] [PubMed] [Google Scholar]
  • 9.Pollack MM, Dunbar BS, Holbrook PR, Fields AI. Aspiration of activated charcoal and gastric contents. Ann Emerg Med. 1981;10:528–529. doi: 10.1016/S0196-0644(81)80009-1. [DOI] [PubMed] [Google Scholar]
  • 10.Justiniani FR, Hippalgaonkar R, Martinez LO. Charcoal-containing empyema complicating treatment for overdose. Chest. 1985;87(3):404–405. doi: 10.1378/chest.87.3.404. [DOI] [PubMed] [Google Scholar]
  • 11.Menzies DG, Busuttil A, Prescott LF. Fatal pulmonary aspiration of oral activated charcoal. BMJ. 1988;297:459–460. doi: 10.1136/bmj.297.6646.459. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Elliott CG, Colby TV, Kelly TM, Hicks HG. Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. Chest. 1989;96:672–674. doi: 10.1378/chest.96.3.672. [DOI] [PubMed] [Google Scholar]
  • 13.Matthew H, Mackintosh TF, Tompsett SL, Cameron JC. Gastric aspiration and lavage in acute poisoning. BMJ. 1966;1:1333–1337. doi: 10.1136/bmj.1.5499.1333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Harstad E, Moller KO, Simesen MH. U ber den Wert der Magenspu lung bei der Behandlung von akuten Vergiftungen. Acta Med Scand. 1942;112:478–514. [Google Scholar]
  • 15.Krenzelok EP, McGuigan M, Lheur P. Position statement: ipecac syrup. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. 1997;35(7):699–709. doi: 10.3109/15563659709162567. [DOI] [PubMed] [Google Scholar]
  • 16.Chyka PA, Seger D, Krenzelok EP, Vale JA. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. Position paper: single-dose activated charcoal. Clin Toxicol (Phila) 2005;43(2):61–87. doi: 10.1081/clt-200051867. [DOI] [PubMed] [Google Scholar]
  • 17.American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. J Toxicol Clin Toxicol. 1999;37(6):731–751. doi: 10.1081/CLT-100102451. [DOI] [PubMed] [Google Scholar]
  • 18.Vale JA. Position statement: gastric lavage. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. 1997;35(7):711–719. doi: 10.3109/15563659709162568. [DOI] [PubMed] [Google Scholar]
  • 19.Henry JA, Hoffma JR. Continuing controversy on gut decontamination (Commentary) Clin Toxicol. 1998;36(7):753–755. doi: 10.3109/15563659809162631. [DOI] [PubMed] [Google Scholar]
  • 20.Hoffman RS. Does consensus equal correctness? (Forum) Clin Toxicol. 2000;38(7):689–690. doi: 10.1081/CLT-100102379. [DOI] [PubMed] [Google Scholar]
  • 21.Bond JR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state of the art review. Ann Emerg Med. 2002;39:273–286. doi: 10.1067/mem.2002.122058. [DOI] [PubMed] [Google Scholar]
  • 22.Seger D. Single-dose activated charcoal—back up and reassess. Clin Toxicol. 2004;42(1):101–110. doi: 10.1081/CLT-120028754. [DOI] [PubMed] [Google Scholar]
  • 23.Greene S, Harris C, Singer J. Gastrointestinal decontamination of the poisoned patient. Pediatr Emerg Care. 2008;24(3):176–189. doi: 10.1097/PEC.0b013e318166a092. [DOI] [PubMed] [Google Scholar]
  • 24.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. [Google Scholar]
  • 25.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 25. [Google Scholar]
  • 26.Cooney DO. A “superactivated” charcoal for antidotal use in poisonings. Clin Toxicol. 1977;11(4):387–390. doi: 10.3109/15563657708988201. [DOI] [PubMed] [Google Scholar]
  • 27.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 29. [Google Scholar]
  • 28.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 31. [Google Scholar]
  • 29.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 186. [Google Scholar]
  • 30.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 214. [Google Scholar]
  • 31.Chin L, Picchioni AL, Bourn WM, Laird HE. Optimal antidotal dose of activated charcoal. Toxicol Appl Pharmacol. 1973;26:103–108. doi: 10.1016/0041-008X(73)90090-2. [DOI] [PubMed] [Google Scholar]
  • 32.Jurgens C, Groth Hoegberg LC, Graudal NA. The effect of activated charcoal on drug exposure in healthy volunteers: a meta-analysis. Clin Pharmacol Ther. 2009;85(5):501–505. doi: 10.1038/clpt.2008.278. [DOI] [PubMed] [Google Scholar]
  • 33.Decker WJ, Combs HF, Corby DG. Adsorption of drugs and poisons by activated charcoal. Toxicol Appl Pharmacol. 1968;13:454–460. doi: 10.1016/0041-008X(68)90122-1. [DOI] [PubMed] [Google Scholar]
  • 34.Favin FD, Klein-Schwartz W, Oderda GM, Rose SR. In vitro study of lithium carbonate adsorption by activated charcoal. Clin Toxicol. 1988;26(7):443–450. doi: 10.3109/15563658809038560. [DOI] [PubMed] [Google Scholar]
  • 35.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 11. [Google Scholar]
  • 36.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 440. [Google Scholar]
  • 37.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. p. 235. [Google Scholar]
  • 38.Decker WJ, Corby DG, Hilburn RE, Lynch RE. Adsorption of solvents by activated charcoal, polymers and mineral sorbents. Vet Hum Toxicol. 1981;23(Suppl 1):44–46. [PubMed] [Google Scholar]
  • 39.Cooney DO. Activated charcoal in medical applications. New York: Marcel Dekker; 1995. pp. 197–294. [Google Scholar]
  • 40.Curtis RA, Barone J, Giacona N. Efficacy of ipecac and activated charcoal/cathartic. Prevention of salicylate absorption in a simulated overdose. Arch Int Med. 1984;144:48–52. doi: 10.1001/archinte.144.1.48. [DOI] [PubMed] [Google Scholar]
  • 41.Tenenbein M, Cohen S, Sitar DS. Efficacy of ipecac-induced emesis, orogastric lavage, and activated charcoal for acute overdose. Ann Emerg Med. 1987;16:838–841. doi: 10.1016/S0196-0644(87)80518-8. [DOI] [PubMed] [Google Scholar]
  • 42.Yeates PJA, Thomas SHL. Effectiveness of delayed activated charcoal administration in simulated paracetamol (acetaminophen) overdose. Br J Clin Pharmacol. 2000;49:11–14. doi: 10.1046/j.1365-2125.2000.00107.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Green R, Grierson R, Sitar DS, Tenenbein M. How long after drug ingestion is activated charcoal still effective? Clin Toxicol. 2001;39(6):601–605. doi: 10.1081/CLT-100108492. [DOI] [PubMed] [Google Scholar]
  • 44.Green R, Sitar DS, Tenenbein M. Effect of anticholinergic drugs on the efficacy of activated charcoal. J Toxicol Clin Toxicol. 2004;42(3):267–272. doi: 10.1081/CLT-120037426. [DOI] [PubMed] [Google Scholar]
  • 45.Mullins M, Froelke BR, Rivera MR. Effect of delayed activated charcoal on acetaminophen concentration after simulated overdose of oxycodone and acetaminophen. Clin Toxicol. 2009;47:112–115. doi: 10.1080/15563650802093681. [DOI] [PubMed] [Google Scholar]
  • 46.Kirshenbaum LA, Matthews SC, Sitar DS, Tenenbein M. Whole-bowel irrigation versus activated charcoal in sorbitol for the ingestion of modified-release pharmaceuticals. Clin Pharmacol Ther. 1989;46(3):264–271. doi: 10.1038/clpt.1989.137. [DOI] [PubMed] [Google Scholar]
  • 47.Laine K, Kivisto KT, Neuvonen PJ. Effect of delayed administration of activated charcoal on the absorption of conventional and slow-release verapamil. Clin Toxicol. 1997;35(3):263–268. doi: 10.3109/15563659709001210. [DOI] [PubMed] [Google Scholar]
  • 48.Minton NA, Henry JA. Prevention of drug absorption in simulated theophylline overdose. Clin Toxicol. 1995;33(1):43–49. doi: 10.3109/15563659509020214. [DOI] [PubMed] [Google Scholar]
  • 49.Comstock EG, Boisaubin EV, Comstock BS, Faulkner TP. Assessment of the efficacy of activate charcoal, following gastric lavage in acute drug emergencies. J Toxicol Clin Toxicol. 1982;19(2):149–165. doi: 10.3109/15563658208990377. [DOI] [PubMed] [Google Scholar]
  • 50.Hulten BA, Adams R, Askenasi R, Dallos V, Dawling S. Activated charcoal in acute tricyclic antidepressant poisoning. Hum Exp Toxicol. 1988;7:307–310. doi: 10.1177/096032718800700402. [DOI] [PubMed] [Google Scholar]
  • 51.Underhill TJ, Greene MK, Dove AF. A comparison of the efficacy of gastric lavage, ipecacuanha and activated charcoal in the emergency management of paracetamol overdose. Arch Emerg Med. 1990;7:148–154. doi: 10.1136/emj.7.3.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52.Buckley NA, Whyte IM, O’Connell DL, Dawson AH. Activated charcoal reduces the need for N-acetylcysteine treatment after acetaminophen (paracetamol) overdose. Clin Toxicol. 1999;37(6):753–757. doi: 10.1081/CLT-100102452. [DOI] [PubMed] [Google Scholar]
  • 53.Spiller HA, Winter ML, Klein-Schwartz W, Bangh SA. Efficacy of activated charcoal when administered more than four hours after acetaminophen overdosed. J Emerg Med. 2006;30(1):1–5. doi: 10.1016/j.jemermed.2005.02.019. [DOI] [PubMed] [Google Scholar]
  • 54.Spiller HA, Sawyer TS. Impact of activated charcoal after acute acetaminophen overdoses treated with N-acetylcysteine. J Emerg Med. 2007;33(2):141–144. doi: 10.1016/j.jemermed.2007.02.016. [DOI] [PubMed] [Google Scholar]
  • 55.Friberg LE, Isbister GK, Duffull SB. Pharmacokinetic-pharmacodynamic modelling of QT interval prolongation following citalopram overdoses. Br J Clin Pharmacol. 2006;61(2):177–190. doi: 10.1111/j.1365-2125.2005.02546.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Isbister GK, Friberg LE, Stokes B, Buckley NA, Lee C, Gunja N, Brown SG, Macdonald E, Graudins A, Holdgate A, Duffull SB. Activated charcoal decreases the risk of QT prolongation after citalopram overdose. Ann Emerg Med. 2007;50:593–600. doi: 10.1016/j.annemergmed.2007.03.009. [DOI] [PubMed] [Google Scholar]
  • 57.Friberg LE, Isbister GK, Hackett LP, Duffill SB. The population pharmacokinetics of citalopram after deliberate self-poisoning: a Bayesian approach. J Pharmacokinet Pharmacodyn. 2005;32:571–605. doi: 10.1007/s10928-005-0022-6. [DOI] [PubMed] [Google Scholar]
  • 58.Isbister GK, Friberg LE, Hackett LP, Duffill SB. Pharmacokinetics of quetiapine in overdose and the effect of activated charcoal. Clin Pharmacol Ther. 2007;81:821–827. doi: 10.1038/sj.clpt.6100193. [DOI] [PubMed] [Google Scholar]
  • 59.Kumar VVP, Oscarsson S, Friberg LE, Isbister GK, Hackett LP, Duffill SB. The effect of decontamination procedures on the pharmacokinetics of venlafaxine in overdose. Clin Pharmacol Ther. 2009;86(4):403–410. doi: 10.1038/clpt.2009.114. [DOI] [PubMed] [Google Scholar]
  • 60.Roberts DM, Southcott E, Potter JM, Roberts MS, Eddleston M, Buckley NA. Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal. Ther Drug Monit. 2006;28(6):784–792. doi: 10.1097/FTD.0b013e31802bfd69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61.de Silva HA, Fonseka MMD, Pathmeswaran A, Alahakone DGS, Ratnatilake GA, Gunatilake SB, Ranasinha CD, Lalloo DG, Aronson JK, de Silva HJ. Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial. Lancet. 2003;361:1935–1938. doi: 10.1016/S0140-6736(03)13581-7. [DOI] [PubMed] [Google Scholar]
  • 62.Eddleston M, Juszczak E, Buckley NA, Senarathna L, Mohamed F, Dissanayake W, Hittarage A, Azher S, Jeganathan K, Jayamanne S, Sheriff MHR, Warrell DA. Mutliple-dose activated charcoal in acute self-poisoning: a randomised controlled trial. Lancet. 2008;371:579–587. doi: 10.1016/S0140-6736(08)60270-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 63.Merigian KS, Blaho KE. Single-dose oral activated charcoal in the treatment of the self-poisoned patient: a prospective, randomized, controlled trial. Am J Ther. 2002;9:301–308. doi: 10.1097/00045391-200207000-00007. [DOI] [PubMed] [Google Scholar]
  • 64.Cooper GM, Le Couteur DG, Richardson D, Buckley NA. A randomized clinical trial of activated charcoal for the routine management of oral drug overdose. QJ Med. 2005;98:655–660. doi: 10.1093/qjmed/hci102. [DOI] [PubMed] [Google Scholar]
  • 65.Eddleston M, Haggalla S, Reginald K, Sudarshan K, Senthilkumaran M, Karalliedde L, Ariaratnam A, Sheriff MHR, Warrall DA, Buckley NA. The hazards of gastric lavage for intentional self-poisoning in a resource poor location. Clin Toxicol. 2007;45(2):136–143. doi: 10.1080/15563650601006009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Gomez HF, Brent JA, Munoz DC, Mimmack RF, Ritvo J, Phillips S, McKinney P. Charcoal stercolith with intestinal perforation in a patient treated for amitriptyline ingestion. J Emerg Med. 1994;12(1):57–60. doi: 10.1016/0736-4679(94)90013-2. [DOI] [PubMed] [Google Scholar]
  • 67.Erolgu AH, Kucuktulu U, Erciyes N, Turgutalp H. Multiple dose activated charcoal as a cause of acute appendicitis. J Toxicol Clin Toxicol. 2002;41(1):71–73. doi: 10.1081/clt-120018274. [DOI] [PubMed] [Google Scholar]
  • 68.Green JP, McCauley W. Bowel perforation after single-dose activated charcoal. Can J Emerg Med. 2006;8(5):358–360. doi: 10.1017/s1481803500014081. [DOI] [PubMed] [Google Scholar]
  • 69.Vilska J. Indications and contraindications of activated charcoal in a poison control center. The viewpoint of the Poison Control Center of Finland. J Toxicol Clin Exp. 1989;9(4):295–298. [PubMed] [Google Scholar]
  • 70.Spiller HA, Rodgers GC. Evaluation of administration of activated charcoal in the home. Pediatrics. 2001;108(6):E100. doi: 10.1542/peds.108.6.e100. [DOI] [PubMed] [Google Scholar]
  • 71.Kornberg AE, Dolgin J. Pediatric ingestions: charcoal alone versus ipecac and charcoal. Ann Emerg Med. 1991;20:648–651. doi: 10.1016/S0196-0644(05)82385-6. [DOI] [PubMed] [Google Scholar]
  • 72.Osterhoudt KC, Alpern ER, Durbin D, Nadel F, Henretig FM. Activated charcoal administration in a pediatric emergency department. Pediatr Emerg Care. 2004;20(8):493–498. doi: 10.1097/01.pec.0000136064.14704.d1. [DOI] [PubMed] [Google Scholar]
  • 73.Guenther Skokan E, Junkins EP, Corneli HM, Schunk JE. Taste test: children rate flavoring agents used with activated charcoal. Arch Pediatr Adolesc Med. 2001;155:683–686. doi: 10.1001/archpedi.155.6.683. [DOI] [PubMed] [Google Scholar]
  • 74.Dagnone D, Matsui D, Rieder MJ. Assessment of the palatability of vehicles for activated charcoal in pediatric volunteers. Pediatr Emerg Care. 2002;18(1):19–21. doi: 10.1097/00006565-200202000-00006. [DOI] [PubMed] [Google Scholar]
  • 75.Cheng A, Ratnapalan S. Improving the palatability of activated charcoal in pediatric patients. Pediatr Emerg Care. 2007;23(6):384–386. doi: 10.1097/01.pec.0000278402.45321.f6. [DOI] [PubMed] [Google Scholar]
  • 76.Boyd R, Hanson J. Prospectuve single blinded randomised controlled trial of two orally administered activated charcoal preparations. J Accid Emerg Med. 1999;16:24–25. doi: 10.1136/emj.16.1.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Minocha A, Wiley SH, Chabbra DR, Harper CR, Spyker DA. Superior efficacy of sorbitol cathartics in poisoned patients [abstract] Vet Hum Toxicol. 1986;5:494. [Google Scholar]
  • 78.Osterhoudt KC, Durbin D, Alpern ER, Henretig FM. Risk factors for emesis after therapeutic use of activated charcoal in acutely poisoned children. Pediatrics. 2004;113:806–810. doi: 10.1542/peds.113.4.806. [DOI] [PubMed] [Google Scholar]
  • 79.Eizember FL, Tomaszewski CA, Kerns WP. Acupressure for prevention of emesis in patients receiving activated charcoal. J Toxicol Clin Toxicol. 2002;40(6):775–780. doi: 10.1081/CLT-120015838. [DOI] [PubMed] [Google Scholar]
  • 80.Harris CR, Filandrinos D. Accidental administration of activated charcoal into the lung: aspiration by proxy. Ann Emerg Med. 1993;22:1470–1473. doi: 10.1016/S0196-0644(05)81998-5. [DOI] [PubMed] [Google Scholar]
  • 81.Sabga E, Dick A, Lertzman M, Tenenbein M. Direct administration of charcoal into the lung and pleural cavity. Ann Emerg Med. 1997;30:695–697. doi: 10.1016/S0196-0644(97)70090-8. [DOI] [PubMed] [Google Scholar]
  • 82.Graff GR, Stark J, Berkenbosch JW, Holcomb GW, Garola RE. Chronic lung disease after activated charcoal aspiration. Pediatrics. 2002;109:959–961. doi: 10.1542/peds.109.5.959. [DOI] [PubMed] [Google Scholar]
  • 83.Isbister GK, Downes F, Sibbritt D, Dawson AH, Whyte IM. Aspiration pneumonitis in an overdose population: frequency, predictors, and outcomes. Crit Care Med. 2004;32(1):88–93. doi: 10.1097/01.CCM.0000104207.42729.E4. [DOI] [PubMed] [Google Scholar]
  • 84.Adnet F, Baud F. Relation between Glasgow Coma Scale and aspiration pneumonia. Lancet. 1996;348(9020):123–124. doi: 10.1016/S0140-6736(05)64630-2. [DOI] [PubMed] [Google Scholar]
  • 85.Moll K, Kerns W, 2nd, Tomaszewski C, Rose R. Incidence of aspiration pneumonia in intubated patients receiving activated charcoal. J Emerg Med. 1999;17(2):279–283. doi: 10.1016/S0736-4679(98)00192-9. [DOI] [PubMed] [Google Scholar]
  • 86.Lee AG, Wagner FM, Chen MF, Serrick C, Giaid C, Shennib H. A novel charcoal-induced model of obliterative bronchiolitis-like lesions: implications of chronic nonspecific airway inflammation in the development of posttransplantation obliterative bronchiolitis. J Thorac Cardiovasc Surg. 1998;115(4):822–827. doi: 10.1016/S0022-5223(98)70362-9. [DOI] [PubMed] [Google Scholar]
  • 87.Arnold TC, Willis BH, Xiao F, Conrad SA, Carden DL. Aspiration of activated charcoal elicits an increase in lung microvascular permeability. Clin Toxicol. 1999;37(1):9–16. doi: 10.1081/CLT-100102402. [DOI] [PubMed] [Google Scholar]
  • 88.Tomaszewski CA. Activated charcoal—treatment or toxin? (Commentary) Clin Toxicol. 1999;37(1):17–18. doi: 10.1081/CLT-100102403. [DOI] [PubMed] [Google Scholar]
  • 89.Juurlink DN, McGuigan MA. Gastrointestinal decontamination for enteric-coated aspirin overdose: what to do depends on who you ask. Clin Toxicol. 2000;38(5):465–470. doi: 10.1081/CLT-100102004. [DOI] [PubMed] [Google Scholar]
  • 90.Bailey B. Gastrointestinal decontamination triangle (letter) Clin Toxicol. 2005;1:59–60. doi: 10.1081/clt-45064. [DOI] [PubMed] [Google Scholar]
  • 91.Bailey B. To decontaminate or not to decontaminate? The balance between potential risks and forseeable benefits. Clin Pediatr Emerg Med. 2008;9:17–23. doi: 10.1016/j.cpem.2007.11.001. [DOI] [Google Scholar]
  • 92.Wiegand TJ, Wu L, Dempsey DA. Algorithm for activated charcoal (AC) use for ingestions [abstract] Clin Toxicol. 2005;43(6):673. [Google Scholar]

Articles from Journal of Medical Toxicology are provided here courtesy of Springer

RESOURCES