Because there are few specific antagonists for ingested toxic substances, medical treatment
consists primarily of supportive measures and attempts to decrease systemic absorption
by a variety of gastrointestinal decontamination measures. Over the past several
years it has become increasingly clear that, at least for drug ingestions treated in emergency
departments, stomach-emptying techniques such as induced emesis and gastric
aspiration/lavage result in little benefit in terms of improved clinical outcome. These
measures also result in delayed administration of activated charcoal, whose clinical
efficacy has been well demonstrated. Current clinical practice for most cases of drug
ingestion treated in the hospital is to forego gastric emptying in favor of early administration
of activated charcoal. Repeated doses of activated charcoal constitute an active
therapy for removing a number of systemically absorbed substances.
In this extensive and comprehensive review, Professor Cooney explores the history
of activated charcoal in medical practice, describes its chemistry and pharmacology,
details its past and current clinical applications for poisoning treatment, and elucidates
the need for studies of its potential clinical application in gastroenterology and other
medical fields. Health care professionals who treat poisoned patients, as well as pharmacology
and toxicology researchers, will find a wealth of information about activated
charcoal in this volume, which lays a firm foundation for the rational use of activated
charcoal in medical therapy.