The effect of activated charcoal on drug exposure following intravenous administration: A meta-analysis.

Activated charcoal both reduces primary drug absorption and enhances drug elimination. However, the two mechanisms of action overlap and are indistinguishable from each other. In order to estimate the extend of enhanced elimination, we summarized the effect of activated charcoal on intravenously administered drugs, where reduced drug exposure can be attributed to enhanced elimination. We performed a meta-analysis of randomized controlled studies evaluating the effect of orally administered activated charcoal on the systemic exposure of intravenously administered drugs. We searched the bibliographic databases PubMed, Embase and Cochrane. Meta-regression analyses of selected physiochemical drug properties on the effect sizes of activated charcoal were performed. All but one of 21 included studies used multiple-dose activated charcoal (MDAC). MDAC reduced the median half-life of the intravenously administered study drugs by 45.7% (interquartile range: 15.3%-51.3%) and area under the concentration time curve by 47.0% (interquartile range: 36.4%-50.2%). MDAC significantly improved drug elimination across nine different intravenously administered drugs, but we were unable to identify factors allowing extrapolation to other drugs. The results offer a possible and plausible rationale for the previously observed effects of single-dose activated charcoal beyond the timeframe where ingested drug is present in the gastro-intestinal tract.

A Colon-Targeted Adsorbent (DAV132) Does Not Affect the Pharmacokinetics of Warfarin or Clonazepam in Healthy Subjects.

DAV132 is a novel colon-targeted adsorbent that prevents the deleterious impact of antibiotics on gut microbiota without modifying their systemic availability. A randomized, Latin-square crossover, open-label trial with 2 substudies in 18 and 24 healthy volunteers evaluated the pharmacokinetic (PK) bioequivalence of warfarin, a drug with a narrow therapeutic index (NTI), and clonazepam, both widely used for the treatment of chronic conditions, with or without coadministration of DAV132 7.5 g. PK parameters observed with single doses of 5 mg warfarin and 1 mg clonazepam when administered alone did not differ with the PK parameters when administered concomitantly with or 1 hour before DAV132. Geometric mean ratios (GMRs) for S-warfarin, R-warfarin, and clonazepam Cmax were 102.0, 102.8, and 91.9, respectively, after concomitant administration and 106.5, 107.5, and 95.0, respectively, when administered 1 hour before DAV132. After concomitant administration, GMRs for S-warfarin, R-warfarin, and clonazepam AUClast were 100.5, 100.2, and 94.9, respectively, and 101.9, 101.8, and 101.3, respectively, when administered 1 hour before DAV132. All GMR 90% confidence intervals fell within the prespecified 80% to 125% limit for bioequivalence, indicating a lack of drug-drug interaction. In conclusion, DAV132 did not affect the systemic exposure of 2 NTI drugs absorbed in the proximal intestine.

Enhanced biochars can match activated carbon performance in sediments with high native bioavailability and low final porewater PCB concentrations.

A bench scale study was conducted to evaluate the effectiveness of in situ amendments to reduce the bioavailability of pollutants in sediments from a site impacted with polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs) and cadmium. The amendments tested included fine and coarse coal-based activated carbons (AC), an enhanced pinewood derived biochar (EPB), organoclay, and coke dosed at 5% of sediment dry weight. Strong reductions in total PCB porewater concentrations were observed in sediments amended with the fine AC (94.9-99.5%) and EPB (99.6-99.8%). More modest reductions were observed for the coarse AC, organoclay, and coke. Strong reductions in porewater PCB concentrations were reflected in reductions in total PCB bioaccumulation in fresh water oligochaetes for both the fine AC (91.9-96.0%) and EPB (96.1-96.3%). Total PAH porewater concentrations were also greatly reduced by the fine AC (>96.1%) and EPB (>97.8%) treatments. EPB matched or slightly outperformed the fine AC throughout the study, despite sorption data indicating a much stronger affinity of PCBs for the fine AC. Modeling EPB and fine AC effectiveness on other sediments confirmed the high effectiveness of the EPB was due to the very low final porewater concentrations and differences in the native bioavailability between sediments. However, low bulk density and poor settling characteristics make biochars difficult to apply in an aquatic setting. Neither the EPB nor the fine AC amendments were able to significantly reduce Cd bioavailability.

TCDD administered on activated carbon eliminates bioavailability and subsequent shifts to a key murine gut commensal.

Activated carbon (AC) is an increasingly attractive remediation alternative for the sequestration of dioxins at contaminated sites globally. However, the potential for AC to reduce the bioavailability of dioxins in mammals and the residing gut microbiota has received less attention. This question was partially answered in a recent study examining 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced hallmark toxic responses in mice administered with TCDD sequestered by AC or freely available in corn oil by oral gavage. Results from that study support the use of AC to significantly reduce the bioavailability of TCDD to the host. Herein, we examined the bioavailability of TCDD sequestered to AC on a key murine gut commensal and the influence of AC on the community structure of the gut microbiota. The analysis included qPCR to quantify the expression of segmented filamentous bacteria (SFB) in the mouse ileum, which has responded to TCDD-induced host toxicity in previous studies and community structure via sequencing the 16S ribosomal RNA (rRNA) gene. The expression of SFB 16S rRNA gene and functional genes significantly increased with TCDD administered with corn oil vehicle. Such a response was absent when TCDD was sequestered by AC. In addition, AC appeared to have a minimal influence on murine gut community structure and diversity, affecting only the relative abundance of Lactobacillaceae and two other groups. Results of this study further support the remedial use of AC for eliminating bioavailability of TCDD to host and subsequent influence on the gut microbiome.

The effects of autohydrolysis pretreatment on the structural characteristics, adsorptive and catalytic properties of the activated carbon prepared from Eucommia ulmoides Oliver based on a biorefinery process.

Eucommia ulmoides Oliver (EU) wood was consecutively treated by autohydrolysis pretreatment and chemical carbonization post-treatment based on a biorefinery process. Results showed that the optimal condition of the autohydrolysis pretreatment and carbonization process yielded 10.37kg xylooligosaccharides (XOS), 1.39kg degraded hemicellulosic products, 17.29kg other degraded products from hemicelluloses and 40.72kg activated carbon (SBET of 1534.06m2/g) from the 100kg raw materials. Simultaneously, 29.14kg gas products generated from the optimum integrated process was significantly lower than that from the direct carbonization process (68.84kg). Besides, the optimal activated carbon (AC170-1.0) also showed a moderate catalytic activity and high stability for hydrogen production by catalytic methane decomposition. Overall, the data presented indicated that the integrated process is an eco-friendly and efficient process to produce XOS and activated carbon, which is beneficial for value-added and industrial application of EU wood.

Biochars with excellent Pb(II) adsorption property produced from fresh and dehydrated banana peels via hydrothermal carbonization.

Fresh and dehydrated banana peels were used as biomass feedstock to produce highly effective sorbent biochars through a facile one-step hydrothermal carbonization approach with 20%vol phosphoric acid as the reaction medium. The elemental ratio of oxygen content of the two as-prepared biochars were about 20%, and the FT-IR analysis confirmed the existence of abundant surface functional groups such as hydroxyl and carboxyl which greatly enhanced the adsorption performance. The sorbents showed excellent lead clarification capability of 359mg·g-1 and 193mg·g-1 for dehydrated and fresh banana peels based biochars, respectively. The change of the CO/OCO and the appearance of PbO/PbOC on the surface after adsorption confirmed that the ion exchange might be the dominant mechanism. The dehydration and pulverization pre-treatment and the addition of phosphoric acid can benefit the formation of those functional groups and hydrothermal carbonization can be a promising method to transfer biomass like fruit peels into biochars with excellent adsorption performance.

Impact of torrefaction and low-temperature carbonization on the properties of biomass wastes from Arundo donax L. and Phoenix canariensis.

The impact of torrefaction and low-temperature carbonization on the properties of biomass wastes from Arundo donax L. and Phoenix canariensis was studied. Thermal treatments were performed at temperatures from 200°C to 350°C during 15 to 90min and temperature was the parameter that more influenced mass and energy yields as well as biochar composition. Torrefaction reduced moisture, volatile matter, O/C and H/C ratios of the biomass, while increasing heating value, ash content and fixed carbon. For torrefaction at 250°C or higher temperatures grindability of the biochars was significantly improved. The low volatile matter contents and high ash contents of these biochars restricts their use as solid fuels but they can be valorized otherwise. Raw biomasses and the biochars torrefied at 200°C could remove methylene blue from an aqueous solution, in fast adsorption test with a contact time of only 3s, with efficiencies higher than 50%.

Effects of three different biochars on aggregate stability, organic carbon mobility and micronutrient bioavailability.

Previous studies have demonstrated both beneficial and detrimental effects on soil properties from biochar incorporation. Several biochars, with different feedstock origins, were evaluated for their effectiveness at improving soil quality of a sandy agricultural soil. A pot trial was used to investigate aggregate stability and microbial activity, pore water trace element mobility and micronutrient concentrations in grain of spring wheat after incorporation of three biochars. The feedstocks for biochar production were selected because they were established UK waste products, namely oversize woody material from green waste composting facilities, and rhododendron and soft wood material from forest clearance operations. Biochars were incorporated into the soil at a rate of 5% v/v. Aggregate stability was improved following addition of oversize biochar whilst microbial activity increased in all treatments. Dissolved organic carbon (DOC) concentrations in soil pore water from biochar-treated soils were raised, whilst micronutrient concentrations in wheat grain grown in the treated soils were significantly reduced. It was concluded that incorporation of biochar to temperate agricultural soils requires caution as it may result in reductions of essential grain micronutrients required for human health, whilst the effect on aggregate stability may be linked to organic carbon functional groups on biochar surfaces and labile carbon released from the char into the soil system.

Mesoporous Bamboo Charcoal Nanoparticles as a New Near-Infrared Responsive Drug Carrier for Imaging-Guided Chemotherapy/Photothermal Synergistic Therapy of Tumor.

Near-infrared-(NIR)-light-triggered photothermal nanocarriers have attracted much attention for the construction of more smart and effective therapeutic platforms in nanomedicine. Here, a multifunctional drug carrier based on a low cost, natural, and biocompatible material, bamboo charcoal nanoparticles (BCNPs), which are prepared by the pyrolysis of bamboo followed by physical grinding and ultrasonication is reported. The as-prepared BCNPs with porous structure possess not only large surface areas for drug loading but also an efficient photothermal effect, making them become both a suitable drug carrier and photothermal agent for cancer therapy. After loading doxorubicin (DOX) into the BCNPs, the resulting DOX-BCNPs enhance drug potency and more importantly can overcome the drug resistance of DOX in a MCF-7 cancer cell model by significantly increasing cellular uptake while remarkably decreasing drug efflux. The in vivo synergistic effect of combining chemotherapy and photothermal therapy in this drug delivery system is also demonstrated. In addition, the BCNPs enhance optoacoustic imaging contrast due to their high NIR absorbance. Collectively, it is demonstrated that the BCNP drug delivery system constitutes a promising and effective nanocarrier for simultaneous bioimaging and chemo-photothermal synergistic therapy of cancer.

Remediation of lead contaminated soil by biochar-supported nano-hydroxyapatite.

In this study, a high efficiency and low cost biochar-supported nano-hydroxyapatite (nHAP@BC) material was used in the remediation of lead (Pb)-contaminated soil. The remediation effect of nHAP@BC on Pb-contaminated soil was evaluated through batch experiments. The stability, bioaccessibility of Pb in the soil and the change in soil characteristics are discussed. Furthermore, the effects of the amendments on the growth of cabbage mustard seedlings and the accumulation of Pb were studied. The results showed that the immobilization rates of Pb in the soil were 71.9% and 56.8%, respectively, after a 28 day remediation using 8% nHAP and nHAP@BC materials, and the unit immobilization amount of nHAP@BC was 5.6 times that of nHAP, indicating that nHAP@BC can greatly reduce the cost of remediation of Pb in soil. After the nHAP@BC remediation, the residual fraction Pb increased by 61.4%, which greatly reduced the bioaccessibility of Pb in the soil. Moreover, nHAP@BC could effectively reduce the accumulation of Pb in plants by 31.4%. Overall, nHAP@BC can effectively remediate Pb-contaminated soil and accelerate the recovery of soil fertility.

The effects of prucalopride on postoperative ileus in guinea pigs.

PURPOSE: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. MATERIALS AND METHODS: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. RESULTS: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. CONCLUSION: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.

Effect of fermentation inhibitors in the presence and absence of activated charcoal on the growth of Saccharomyces cerevisiae.

The acidic hydrolysis of biomass generates numerous inhibitors of fermentation, which adversely affect cell growth and metabolism. The goal of the present study was to determine the effects of fermentation inhibitors on growth and glucose consumption by Saccharomyces cerevisiae. We also conducted in situ adsorption during cell cultivation in synthetic broth containing fermentation inhibitors. In order to evaluate the effect of in situ adsorption on cell growth, five inhibitors, namely 5-hydroxymethylfurfural, levulinic acid, furfural, formic acid, and acetic acid, were introduced into synthetic broth. The existence of fermentation inhibitors during cell culture adversely affects cell growth and sugar consumption. Furfural, formic acid, and acetic acid were the most potent inhibitors in our culture system. The in situ adsorption of inhibitors by the addition of activated charcoal to the synthetic broth increased cell growth and sugar consumption. Our results indicate that detoxification of fermentation media by in situ adsorption may be useful for enhancing biofuel production.

The Effects of Prucalopride on Postoperative Ileus in Guinea Pigs

PURPOSE: Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalization. The aim of this study was to investigate the effects of different 5-hydroxytryptamine 4 (5-HT4) receptor agonists, which stimulate excitatory pathways, on a POI model. MATERIALS AND METHODS: The experimental model of POI in guinea pigs was created by laparotomy, gentle manipulation of the cecum for 60 seconds, and closure by suture, all under anesthesia. Different degrees of restoration of GI transit were measured by the migration of charcoal. Colonic transit was indirectly assessed via measurement of fecal pellet output every hour for 5 hours after administration of various doses of mosapride, tegaserod, prucalopride, and 5-HT. RESULTS: Charcoal transit assay showed that various 5-HT4 receptor agonists can accelerate delayed upper GI transit in a dose-dependent manner. However, fecal pellet output assay suggested that only prucalopride had a significant effect in accelerating colonic motility in POI. CONCLUSION: Although mosapride, tegaserod, and prucalopride produce beneficial effects to hasten upper GI transit in the POI model, prucalopride administered orally restores lower GI transit as well as upper GI transit after operation in a conscious guinea pig. This drug may serve as a useful candidate for examination in a clinical trial for POI.

Efecto del carbón activado y ácido indol acético en el desarrollo de protocormos de masdevallia coccinea linden ex lindl. y maxillaria nutans lindl: in vitro / Effect of activated charcoal indol and acetic acid in the development of masdevallia coccinea linden ex lindl y maxillaria nutans lindl. protocorm like bodies under in vitro

En esta investigación se pretende estimular el desarrollo de protocormos de Masdevallia coccinea y Maxillaria nutans bajo condiciones in vitro utilizando diferentes concentraciones de ácido indol acético y carbón activado. El protocolo obtenido es una alternativa de la conservación de orquídeas que se encuentran en vías de extinción, y además permite contribuir con el mejoramiento medioambiental. En la evaluación del desarrollo vegetativo bajo condiciones in vitro de los protocormos de Masdevallia coccinea y Maxillaria nutans, orquídeas en vías de extinción, se obtuvo que solamente Maxillaria nutans alcanzará su desarrollo exitoso mediante el cultivo in vitro en el medio Murashige y Skoog (1962), donde se evaluó el efecto de la interacción entre el carbón activado (0,0; 0,5, 1,0 % (p/v)) y el ácido indol acético (0,0; 0,5; 1,0 mg/L-1). El medio de cultivo empleado fue enriquecido con sacarosa al 3% y el Myo inositol al 0,1 g/L-1. Los protocormos de Masdevallia coccinea evidenciaron que se encontraban inmaduros, situación por la cual no lograron su desarrollarlo vegetativo en el experimento planteado, en atención a que se encontraban en el periodo de latencia. Por esta razón, es de gran importancia tener en cuenta que las cápsulas de las orquídeas deben estar bien maduras, a fin de garantizar que los protocormos que se forman in vitro sean maduros y completen con facilidad su morfofisiológía. Mientras que los protocormos de Maxillaria nutans dieron un mayor rendimiento en su desarrollo vegetativo. En esta investigación se determinó que el efecto de la interacción de 0,5% de carbón activado con 0,5 mg/L-1 de AIA es positivo sobre la tasa de crecimiento para el desarrollo de los protocormos de Maxillaria nutans bajo condiciones in vitro.

The evaluation of protocorms growth of Masdevallia coccinea and Maxillaria nutans under in vitro conditions, endangered orchids, it got only Maxillaria nutans reached its successful development by culture in vitro in Murashige and Skoog (1962), which evaluated the effect of the interaction between the activated carbon (0.0, 0.5, 1,0% (w / v)) and indole acetic acid (0.0, 0.5, 1.0 mg.L-1). The culture medium used was enriched with 3% sucrose and 0.1 g/L-1 Myo inositol. Protocorms of Masdevallia coccinea, showed that they were immature, state why they did not achieve their vegetative development in the experiment raised, considering that they were in the latency period. It is therefore very important to note that the capsules of the orchid should be ripe, to ensure that protocorms formed in vitro are mature and they respond with ease morphphysiology development. While protocorms of Maxillaria nutans, gave a higher yield in its vegetative development. This research found that the interaction effect of 0.5% activated carbon with 0.5 mg/L-1 of IAA is positive on the growth rate for the development of Maxillaria nutans protocorms under in vitro conditions. The protocol obtained in this investigation is an alternative of conservation of orchids that are endangered and can contribute to further environmental improvement.

Drug adsorption efficacy and palatability of a novel charcoal cookie formulation.

STUDY OBJECTIVES: To determine the effect of a novel charcoal cookie formulation compared with a standard aqueous charcoal product on the absorption of orally administered cimetidine, and to compare the palatability of the two charcoal products. DESIGN: Prospective, open-label, three-way, crossover trial. SETTING: General clinical research center. SUBJECTS: Eight healthy volunteers (five men, three women; mean age 23.4 yrs). INTERVENTION: After an overnight fast, each subject ingested a single cimetidine 800-mg tablet. Fifteen minutes later, subjects were randomly assigned to receive either water (control), three charcoal cookies (equivalent to 7.2 g of charcoal), or 7.2 g of aqueous activated charcoal suspension. Subjects then received each of the other study treatments-cimetidine with water, cimetidine with charcoal cookies, and cimetidine with charcoal suspension-separated by a 1-week washout period between each treatment. MEASUREMENTS AND MAIN RESULTS: Venous blood samples were obtained before and 8 hours after administration of the cimetidine dose. Noncompartmental pharmacokinetic analysis was performed, and area under the plasma concentration-time curve (AUC) and maximum plasma concentration (C(max)) were compared for each study drug combination. In addition, subjects evaluated the palatability of each charcoal product by using a visual analog scale. Both charcoal products effectively adsorbed cimetidine, resulting in decreased absorption of most of the cimetidine dose. No significant difference was noted in the median percent decrease in cimetidine AUC between the charcoal suspension and charcoal cookie (91.8% vs 82.1%, p=0.505). Similarly, no significant difference was noted in the median percent decrease in C(max) between the two charcoal formulations (82.6% vs 64.0%, p=0.574). The palatability scores, however, were significantly higher for the charcoal cookie than for the charcoal suspension. All study drugs were well tolerated, and no adverse events were reported. CONCLUSION: The new charcoal cookie formulation appears to be as effective as the aqueous charcoal suspension at reducing absorption of cimetidine. In addition, the charcoal cookie was rated as more palatable than the aqueous charcoal suspension, suggesting that the charcoal cookie could be an attractive alternative to the charcoal slurry for managing drug overdoses.

Pilot study of targeting magnetic carbon nanotubes to lymph nodes.

AIM: The lymphatic distribution of magnetic carbon nanotubes was studied in vivo and compared with magnetic-activated carbon particles, which were selectively taken up in the lymphatic channels and delivered to the regional lymph nodes. MATERIAL & METHODS: Magnetic multiwalled carbon nanotubes functionalized with poly(acrylic acid) (mMWNTs) and magnetic-activated carbon particles were subcutaneously injected in mice. The draining lymph nodes were harvested at different times postadministration to examine the lymphatic distribution of these particles. The short-term accumulation and toxicity of mMWNTs in the major organs were studied. RESULTS: mMWNTs had the same properties of lymph node mapping as magnetic-activated carbon particles in mice independent of lymph node metastasis. The degree of black staining of lymph nodes and concentration of mMWNTs had a dose-response relationship. Aggregation of magnetic particles was found around the metastatic foci within the lymph nodes. Footpad injection of mMWNTs did not cause any obvious local or systemic toxicities, and no particle agglomerates were found in the major organs. CONCLUSION: The feasibility of targeting magnetic carbon nanotubes to lymph nodes was demonstrated and the results support further studies for their potential use in diagnosing and treating cancer.

Acute respiratory failure after aspiration of activated charcoal with recurrent deposition and release from an intrapulmonary cavern.

OBJECTIVE: To report on the recurrent release of charcoal from an intrapulmonary cavern in a case of acute respiratory failure after charcoal aspiration. DESIGN: Case report. SETTING: Anaesthesiological ICU, university hospital. PATIENT: An 18-year-old ethanol intoxicated comatose patient regurgitated and aspirated activated charcoal during orotracheal intubation. TREATMENT: After 2 days of mechanical ventilation, the patient was transferred to a tertiary care university hospital. On admission, acute respiratory distress syndrome with bilateral pulmonary infiltrations was diagnosed. The patient's recovery was hampered by recurrent release of charcoal from an intrapulmonary cavern. Sophisticated ventilatory support, prone positioning, secretolytics, repetitive bronchoscopy, and antibiotic therapy may have facilitated bronchoalveolar clearance and weaning after 18 days. CONCLUSION: Aspiration may be a dramatic complication if charcoal is administered in comatose patients without airway protection. In this case report, advanced intensive care measures were necessary to tackle the special feature of charcoal release from an intrapulmonary cavern.

Pharm profile: activated charcoal.

Activated charcoal is used to treat many kinds of toxicoses. This article presents basic information about activated charcoal's properties and use.