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February 1992

Multiple-Dose Charcoal and Whole-Bowel Irrigation Do Not Increase Clearance of Absorbed Salicylate

Author Affiliations

From the Departments of Pharmacology and Therapeutics (Ms Mayer and Drs Sitar and Tenenbein), Pediatrics and Child Health (Dr Tenenbein), and Internal Medicine (Drs Sitar and Tenenbein), University of Manitoba, Winnipeg; and the Manitoba Poison Control Centre (Dr Tenenbein).

Arch Intern Med. 1992;152(2):393-396. doi:10.1001/archinte.1992.00400140131028

Background. —  This study assesses whether oral multiple-dose charcoal therapy (MDC) or whole-bowel irrigation (WBI) enhances the excretion of previously absorbed salicylate.

Methods.—  A controlled, randomized, three-limbed crossover protocol was used in nine humans who ingested aspirin. Salicylate levels were measured in serial serum specimens and 32-hour urine collections and kinetic parameters were calculated.

Results.—  There were no differences among the control (CTL), MDC, or WBI groups for area under the serum concentration vs time curve (CTL, 2320±501 mg/L·h MDC, 2040±454 mg/L·h; WBI, 2093±418 mg/L·h) or for urinary salicylates (CTL, 54.9%±9.4%; MDC, 50.9%±8.0%, WBI, 52.4%±13.7% of ingested dose).

Conclusions.—  Our data do not support the use of either MDC or WBI to enhance the excretion of previously absorbed salicylate in poisoned patients. In patients with drug overdoses, a clear rectal effluent remains as the endpoint for WBI.(Arch Intern Med. 1992;152:393-396)