Multiple-dose charcoal and whole-bowel irrigation do not increase clearance of absorbed salicylate.
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.
Mayer
A L
AL
Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada.
Sitar
D S
DS
Tenenbein
M
M
D000284:Administration, Oral; D000328:Adult; D001241:Aspirin / Q000493:pharmacokinetics*; D002606:Charcoal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D007422:Intestines; D008297:Male; D011041:Poisoning / Q000628:therapy; D012459:Salicylates / Q000493:pharmacokinetics; D020156:Salicylic Acid; D007507:Therapeutic Irrigation
D012459:Salicylates; D002606:Charcoal; D020156:Salicylic Acid; D001241:Aspirin