Dogs were given large doses of barbiturates, glutethimide, ethanol, methaqualone, ethchlorvynol, meprobamate, chloral hydrate, paracetamol and aspirin. These were treated by haemoperfusion using a column packed with charcoal coated with an acrylic hydrogel. Clearances for most drugs were significantly higher than those reported for haemodialysis. Minimal clearances of common biochemical entities were observed and although leucocyte and platelet counts were diminished, no deleterious effects attributable to this were encountered. Careful histological examination of tissues derived from perfused dogs revealed no evidence of charcoal emboli.

Acetaminophen↗

PubMed1975

Studies with activated charcoal in the treatment of drug overdosage using the pig as an animal model.

Pigs were given large oral doses of paracetamol, amylobarbitone and amitriptyline. The effect of administering activated charcoal at varying intervals after dosing on the blood drug-level profiles of paracetamol and amylobarbitone was assessed by comparison with the profiles obtained when charcoal therapy was withheld. An appreciable effect on paracetamol absorption was demonstrated when charcoal was given up to 1 h after dosing. The amylobarbitone-dosed pigs exhibited delayed gastro-intestinal absorption of drug and this was substantially reduced by activated charcoal given 4 hrs after dosing. The pigs metabolised amitriptyline at too high a rate for meaningful studies to be undertaken with this drug.

Acetaminophen↗

PubMed1975

Use of charcoal haemoperfusion in the management of severely poisoned patients.

The clinical use of uncoated charcoal haemoperfusion systems, despite their efficacy, has hitherto been prevented by the occurrence of a number of adverse effects including charcoal embolism and marked thrombocytopenia. Charcoal coated with a synthetic hydrogel overcomes many of the disadvantages associated with the use of uncoated material in that there is a much reduced thrombocytopenia and no evidence of charcoal embolism. Six patients, severely poisoned as a result of overdoses of either a barbiturate or glutethimide, were haemoperfused using such a system. Four made complete recoveries, and the two patients who died had both suffered cardiorespiratory arrests before perfusion. In contrast to haemodialysis charcoal haemoperfusion is simple to initiate, less expensive in terms of manpower and equipment, and gives superior clearance data for all barbiturates and glutethimide. We believe that this technique may have a significant role to play in the management of the severely poisoned patient.

Adult↗

PubMed1975

Nitrite test for methaqualone.

Details of a simple qualitative test suitable for detecting milligram quantities of methaqualone are presented. A similar reaction undergone by 2,4, 6-triaminopyrimidine suggests that the mechanism involves diazotisation of an intermediate product.

Methaqualone↗

PubMed1975

Kinetics of salicylate metabolism.

1 Nine patients with rheumatoid arthritis or non-inflammatory backache were given soluble aspirin (65 mg/kg body weight) daily. There was no significant difference between the plasma salicylate of those with rheumatoid arthritis and those with backache. 2 Two patients had plasma salicylate values that differed significantly from the remainder but neither these results nor the marginal differences between plasma salicylate levels of the others could be explained by individual variations in the capacity for excreting salicyluric acid or salicyl phenolic glucuronide. 3 Increasing the dose of aspirin in four patients demonstrated the reduced proportions of salicyluric acid and salicyl phenolic glucuronide excreted at high doses and the increased importance of unchanged salicylic acid as an excretory pathway. These findings are consistent with a limiting capacity for salicyluric acid and salicyl phenolic glucuronide synthesis and excretion. 4 The findings in one patient suggested that inter-subject variations in the capacity for producing salicyl phenolic glucuronide and salicyluric acid may have an effect on plasma salicylate levels at high doses of aspirin.

Arthritis, Rheumatoid↗

PubMed1974