活性碳
活性碳是一種高度多孔的黑色細粉末，在急診中作為**胃腸道吸附劑**，用於處理特定的毒物和藥物過量。 * **臨床要點**：它可作為多種有機化合物的廣效吸附劑，但其療效很大程度上取決於給藥時機（理想情況下為攝入後1-2小時內）以及毒物的特定化學性質。 * 對於小分子、高極性或水溶性化合物（如無機酸、強鹼、酒精、硫酸亞鐵、鋰、硝酸鹽、氯化鈉/氯酸鹽或石油餾分），它**沒有效用**。 * 由於表面積較大，泥狀或懸浮液通常比壓縮錠劑更有效。
作用機制: Activated charcoal possesses an extremely large surface area. It binds to toxins in the upper GI tract via **ion-ion interactions**, **hydrogen bonding**, **dipole forces**, and **Van der Waals forces**. * **Mechanism**: Toxin binds to charcoal in the gut lumen → forms a stable charcoal-toxin complex → prevents systemic absorption → complex is excreted safely in the feces. * **Enterohepatic Recirculation**: For drugs that undergo enterohepatic recycling, repeated doses of activated charcoal can act as a "gut dialyzer," pulling systemic toxins back into the GI lumen to be trapped and excreted.
各物種劑量
- Plant intoxications · 1-5 g/kg · PO · Single or multiple doses · Mix with cathartic (e.g., sodium/magnesium sulfate 250-500 mg/kg or sorbitol 70% 3 ml/kg) if no diarrhea is present.
- Plant intoxications · 1-5 g/kg · PO · Single or multiple doses · Mix with cathartic (e.g., sodium/magnesium sulfate 250-500 mg/kg or sorbitol 70% 3 ml/kg) if no diarrhea is present.
- Gastrointestinal absorbent · 10 mL of a 20% slurry (1 g of charcoal in 5 mL of water) per kg · PO/Orogastric tube · Single dose
- Acute poisoning · 1-4 g/kg · PO/Nasogastric tube · q4-6h · As needed for toxins that are recirculated · After decontamination of the GI tract
- Acute poisoning · 1-4 g/kg in 50-200 mL of water · PO · Single or repeated doses · Concurrent with or within 30 minutes of giving charcoal, give an osmotic cathartic.
- Acute poisoning · 1-5 g/kg · PO · Single dose · Diluted in water at 1 g charcoal/5-10 mL water. Follow in 30 minutes with sodium sulfate oral cathartic.
- After toxin ingestion · 0.5-4 g/kg · PO · Repeat dosing as required if emesis or massive toxin ingestion occurs, or for highly lipid-soluble toxins · As needed · Administer as a slurry in water. General rule: administer at a dose of at least 10 times the volume of intoxicant ingested.
- Gastrointestinal absorbent · 10 mL of a 20% slurry (1 g of charcoal in 5 mL of water) per kg · PO/Orogastric tube · Single dose
- Acute poisoning · 1-4 g/kg · PO/Nasogastric tube · q4-6h · As needed for toxins that are recirculated · After decontamination of the GI tract
- Acute poisoning · 1-4 g/kg in 50-200 mL of water · PO · Single or repeated doses · Concurrent with or within 30 minutes of giving charcoal, give an osmotic cathartic.
- Acute poisoning · 1-5 g/kg · PO · Single dose · Diluted in water at 1 g charcoal/5-10 mL water. Follow in 30 minutes with sodium sulfate oral cathartic.
- After toxin ingestion · 0.5-4 g/kg · PO · Repeat dosing as required if emesis or massive toxin ingestion occurs, or for highly lipid-soluble toxins · As needed · Administer as a slurry in water. General rule: administer at a dose of at least 10 times the volume of intoxicant ingested.
- Plant intoxications · 1-5 g/kg · PO · Single or multiple doses · Mix with cathartic (e.g., sodium/magnesium sulfate 250-500 mg/kg or sorbitol 70% 3 ml/kg) if no diarrhea is present.
- Toxicity · Foals: 250 grams (minimum). Adult horses: up to 750 grams. · Nasogastric tube · Single dose · Make a slurry by mixing with up to 4 L of warm water. Leave in stomach for 20-30 minutes and then give a laxative.
- Plant intoxications · 1-5 g/kg · PO · Single or multiple doses · Mix with cathartic if no diarrhea is present.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Ingestion of mineral acids or caustic alkalis (ineffective and may obscure endoscopic evaluation)
- Patients lacking a gag reflex or actively vomiting (unless airway is protected via intubation)
- GI obstruction or perforation
不良反應
- Emesis (especially with rapid administration)
- Aspiration pneumonia (if aspirated)
- Constipation or diarrhea
- Black feces
- Hypernatremia (especially in small dogs and cats)
- Loose stools and vomiting (associated with sorbitol-containing products)
藥物相互作用
- Other orally administered therapeutic agents · Charcoal will adsorb other drugs; separate administration by at least 3 hours.
- Dairy products · May reduce the adsorptive capacity of activated charcoal.
- Mineral oil · May reduce the adsorptive capacity of activated charcoal.
- Polyethylene glycol / Electrolyte solutions (e.g., Go-Lytely) · May reduce the adsorptive capacity of activated charcoal.
- All orally administered drugs · Reduces the absorption and therefore efficacy of orally administered drugs · major
監測
- Toxin/drug serum levels (if applicable)
- Clinical signs of the specific toxicity
- Serum sodium levels (especially if patient develops neurologic signs like tremors, ataxia, or seizures)
過量
Overdosage or overly rapid administration can cause severe electrolyte abnormalities, specifically **hypernatremia**, due to an osmotic effect pulling water into the GI tract. Treat with reduced sodium fluids (e.g., D5W, 0.45% NaCl) and warm water enemas to alleviate the condition.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。