Charcoal powder 250gm

Pediatric poisoning:

Infants up to 1 year Children from 1-12 years Adolescents from 13-18 years

1 g/kg/dose= 4ml/kg/dose 1-2 g/kg/dose= 4-8ml/kg/dose 50-100gm/dose=

(250gm/liter) (250gm/liter) (200-400ml of prepared slurry
of (250gm/liter))
(or 10-25 g/dose) = (or 25-50 g/dose) =
(40-100ml of prepared slurry (100-200ml of prepared slurry
of (250gm/liter)) of (250gm/liter))

Preparation for administration:

One pack of activated charcoal 250gm in 1liter to 2 liters of tap water (ratio 1:4 to 1:8 ) mixed
vigorously to form a slurry administered orally as soon as possible within 1 hour of poisoning
for maximum effect. May repeat every 4-6 hours until toxic symptoms resolve. Shake the
container thoroughly before each administration.

Precautions:

• Milk, chocolate syrup, ice cream, and sherbet should not be mixed with charcoal
because they may reduce its efficacy. May be necessary in pediatric patients to enhance
their compliance.
• The routine use of single-dose activated charcoal for the management of poisoning is
not recommended.
• Do not use if there is an intestinal obstruction, unprotected airway (aspiration may
occur) or caustic ingestions. Caution is recommended in patients with poor
gastrointestinal motility.
• Administration is contraindicated in the presence of an unprotected airway, in patients
with or at risk of gastrointestinal hemorrhage, perforation, or obstruction, or if
administration would increase the risk of aspiration (i.e., hydrocarbon ingestion).
• Should not be used in the management of acute corrosive or petroleum distillate
ingestion since vomiting can occur following charcoal administration. Charcoal may also
obscure the endoscopic evaluation of gastroesophageal lesions.
• May be administered in an attempt to adsorb any ingested toxic agent (where physical
or other contraindications are not present), but it is known to be much less effective in
 the adsorption of boric acid, cadmium, cyanide, DDT, ethanol, ethylene glycol, iron,
lead, lithium, mercury, methanol, potassium chloride, selenium, strong acid or alkali
(may obscure lesion on endoscopy), and organic solvents.
• Activated charcoal may adsorb therapeutic agents while it remains in the GI tract.
Dosages or route of administration of therapeutic drugs may need to be altered.

References:
www.lexicomp.com
https://www.rxlist.com/consumer_activated_charcoal/drugs-condition.htm
https://www.mayoclinic.org/drugs-supplements/charcoal-activated-oral-route/proper-use/drg-
20070087
https://www.drugs.com/dosage/charcoal.html