Effect of oral activated charcoal on tobramycin clearance

Davis, Robin L.; Koup, Jeffrey R.; Roon, R A; Opheim, Kent E.; Smith, Allison

doi:10.1128/aac.32.2.274

Cited by 9 publications

(6 citation statements)

References 14 publications

(19 reference statements)

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“…A modest but significant decrease (about 15%) was also noted in the half-life of elimination. These findings are in contrast with the results of tobramycin reported on human subjects (Davis et al 1988).…”

Section: Eflect Of Activated Charcoal In Rf Rabbitscontrasting

confidence: 99%

“…Although in one study it has been observed that charcoal was not effective in enhancing the clearance of a therapeutic dose of the aminoglycoside, tobramycin, in normal individuals (Davis et al 1988), these results cannot be extrapolated to subjects with renal failure (RF) or toxic concentrations of aminoglycosides. A significant effect for charcoal in enhancing digoxin elimination has been demonstrated in Patients with RF, but a relatively small effect was seen in normal subjects (Park et al 1985).…”

mentioning

confidence: 99%

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The Effect of Oral Activated Charcoal on the Systemic Clearance of Gentamicin in Rabbits with Acute Renal Failure

Hasan

El–Sayed

Abdelaziz

1990

Journal of Pharmacy and Pharmacology

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The effect of oral administration of activated charcoal on total body clearance of gentamicin administered intravenously (2 mg kg-1) has been studied in normal rabbits and rabbits with induced renal failure. Gastric intubation of a single dose (10 g) of activated charcoal to normal rabbits produced a significant reduction in gentamicin serum concentrations compared to control. Significant differences between treated and control groups, compatible with enhancement of gentamicin elimination, were observed in the calculated pharmacokinetic parameters (Kel, t 1/2, CL and AUC). To examine whether renal failure could augment the effect of activated charcoal in enhancing the systemic clearance of gentamicin, uranyl nitrate was used (0.75 mg kg-1, i.v.) to induce acute renal failure in rabbits. The derived pharmacokinetic parameters of gentamicin during the control phase in these animals were consistent with severe renal failure. The administration of activated charcoal, 2.5 h following gentamicin injection, produced a steeper decline in gentamicin concentration-time profiles and significant changes in Kel, t 1/2 and CL. The Kel and CL values increased to about 200%, while the t 1/2 value decreased to about 50%. The apparent changes in the pharmacokinetic parameters induced by charcoal administration were more marked in rabbits with renal failure than in normal rabbits; however, induction of renal failure did not augment the charcoal-induced clearance of gentamicin quantitatively.

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Section: Eflect Of Activated Charcoal In Rf Rabbitscontrasting

confidence: 99%

mentioning

confidence: 99%

The Effect of Oral Activated Charcoal on the Systemic Clearance of Gentamicin in Rabbits with Acute Renal Failure

Hasan

El–Sayed

Abdelaziz

1990

Journal of Pharmacy and Pharmacology

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“…Enterally administered compounds are effectively bound due to its large surface and high adsorption capacity thereby preventing systemic uptake from the gastrointestinal tract. A number of pharmacokinetic studies in healthy subjects have been conducted to evaluate the efficacy of antidotes in the management of drug overdose [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Influence of activated charcoal on the pharmacokinetics of moxifloxacin following intravenous and oral administration of a 400 mg single dose to healthy males

Staß

Kubitza

Möller

et al. 2005

Brit J Clinical Pharma

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Br J Clin Pharmacol AimsTo evaluate the extent to which enterohepatic recycling circulation contributes to moxifloxacin bioavailability in healthy, males by administration of activated charcoal and to evaluate the efficacy of activated charcoal administration in decreasing systemic concentrations of moxifloxacin in the event of overdose. MethodsNine healthy males, mean age 34 years (range 23-45 years) participated in a single centre, randomized, nonplacebo-controlled, three way crossover study. The pharmacokinetics of moxifloxacin in plasma and urine were determined for up to 96 h following a 400 mg single dose randomly administered on three separate occasions with a minimum washout phase of 1 week. Treatment A was 400 mg moxifloxacin IV as a 1 h infusion, treatment B was 400 mg moxifloxacin IV as a 1 h infusion with oral activated charcoal (5 g directly before the start of the infusion, 5 g immediately after the end of the infusion, and 10 g at 2, 4 and 8 h after the start of the infusion), treatment C was 400 mg oral moxifloxacin with activated charcoal (10 g 15 min before and at 2, 4 and 8 h after drug administration). The subjects underwent a series of clinical and laboratory tests. ResultsSingle 400 mg doses of moxifloxacin (PO and/or IV) were safe and well tolerated. The bioavailability of moxifloxacin was significantly decreased when given with charcoal (AUC = 35.5 (IV reference) vs 5.40 (PO) vs 28.5 (IV) mg l -1 h). Concurrently peak concentrations were lowered C max = 3.38 (IV reference) vs 0.62(PO) vs 2.97 (IV) mg l -1 ) by approximately 85% ( P < 0.05) following oral administration and by 20% after IV treatment ( P < 0.05). Bioavailability amounted to 15.4% (95% confidence interval 9.6, 25.0%) for treatment B while it was 80.4% (95% confidence interval 76.3.6, 84.6%) for treatment C. Terminal half-lives were not affected. The kinetics of urinary excretion corroborated these findings. ConclusionsThe results of this study show that moxifloxacin undergoes pronounced enteric recycling after systemic uptake. In addition, these findings confirm that activated charcoal may be useful in treating moxifloxacin overdose by preventing its absorption. Moxifloxacin charcoal interactionBr J Clin Pharmacol 59 :5 537

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“…• Multiple-dose activated charcoal therapy did not increase the elimination of astemizole, 31 chlorpropamide, 32 sodium valproate, 33 tobramycin 34,35 and vancomycin. 36 • The elimination half-life of amitriptyline, 37 but not of doxepin 38 or imipramine, 39 was also reduced by multiple-dose activated charcoal in volunteer studies.…”

Section: Volunteer Studiesmentioning

confidence: 97%

“…Davis et al 34 administered tobramycin 2.5 mg/kg intravenously over 30 minutes to 6 volunteers. Davis et al 34 administered tobramycin 2.5 mg/kg intravenously over 30 minutes to 6 volunteers.…”

Section: Reprintsmentioning

confidence: 99%

Position Statement and Practice Guidelines on the Use of Multi-Dose Activated Charcoal in the Treatment of Acute Poisoning

Toxicologists¹

1999

Journal of Toxicology: Clinical Toxicology

294

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In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. 1-124 Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not usually considered. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. The Position Statement went through multiple drafts before being approved by the Boards of the two societies.The Position Statement includes a summary statement for ease of use and is supported by detailed documentation which describes the scientific evidence on which the Statement is based. Although many studies in animals and volunteers have demonstrated that multiple-dose activated charcoal increases drug elimination significantly, this therapyhas not yet been shown in a controlled study in poisoned patients to reduce morbidity and mortality. Further studies are required to establish its role and the optimal dosage regimen of charcoal to be administered. Based on experimental and clinical studies, multiple-dose activated charcoal should be considered only if a patient has ingested a life-threatening amount of carbamazepine, dapsone, phenobarbital, quinine, or theophylline. With all This Position Statement is endorsed by the Canadian Association of Poison Control Centres. 731 Clinical Toxicology Downloaded from informahealthcare.com by Nyu Medical Center on 07/28/15For personal use only. ORDER REPRINTS 732AACT and EAPCCT of these drugs there are data to confirm enhanced elimination, though no controlled studies have demonstrated clinical benefit.Although volunteer studies have demonstrated that multiple-dose activated charcoal increases the elimination of amitriptyline, dextropropoxyphene, digitoxin, digoxin, disopyramide, nadolol, phenylbutazone, phenytoin, piroxicam, and sotalol, there are insufficient clinical data to support or exclude the use of this therapy.The use of multiple-dose charcoal in salicylate poisoning is controversial. One animal study and 2 of 4 volunteer studies did not demonstrate increased salicylate clearance with multiple-dose charcoal therapy. Data in poisoned patients are insufficient presently to recommend the use of multiple-dose charcoal therapy for salicylate poisoning.Multiple-dose activated charcoal did not increase the elimination of astemizole, chlorpropamide, doxepin, imipramine, meprobamate, methotrexate, phenytoin, sodium valproate, tobramycin, and vancomycin in experimental and/or clinical studies.Unless a patient has an intact or protected airway, the administration of multiple-dose activated charcoal is contraindicated. It should not be used in the presence of an intestinal obstruction. The need for concurrent administration of cathartics remains unproven and is not recommended. In particular, cathartics shoul...

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Effect of oral activated charcoal on tobramycin clearance

Cited by 9 publications

References 14 publications

The Effect of Oral Activated Charcoal on the Systemic Clearance of Gentamicin in Rabbits with Acute Renal Failure

The Effect of Oral Activated Charcoal on the Systemic Clearance of Gentamicin in Rabbits with Acute Renal Failure

Influence of activated charcoal on the pharmacokinetics of moxifloxacin following intravenous and oral administration of a 400 mg single dose to healthy males

Position Statement and Practice Guidelines on the Use of Multi-Dose Activated Charcoal in the Treatment of Acute Poisoning

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