title: Treatment of acetaminophen ingestion with a superactivated charcoal-cola mixture.
abstract: OBJECTIVE
  We evaluate the adsorptive capacity of a superactivated charcoal-cola mixture to acetaminophen compared with superactivated charcoal alone.
  
  
  METHODS
  This was a triple-arm, prospective, unblinded study of 8 healthy adult human volunteers who ingested 80 mg/kg of acetaminophen. In the control arm of the study, participants ingested acetaminophen alone. In the next arm, acetaminophen was followed by 1 g/kg of superactivated charcoal mixed with water. In the final arm, acetaminophen was followed by 1 g/kg of superactivated charcoal mixed with caffeine-free diet cola. Serum acetaminophen concentrations over 6 hours for each arm were analyzed for area under the time-concentration curve (AUC), peak concentrations, and time to peak concentrations.
  
  
  RESULTS
  AUCs were 298.5+/-82.5 mg-h/L (control), 77.1+/-85.2 mg-h/L (superactivated charcoal), and 81.3 +/- 71.8 mg-h/L (superactivated charcoal-cola). Comparison of AUCs by analysis of variance revealed mean square of 128,315.1 between treatments, and residual mean square of 6,405.0, yielding an F ratio of 20.03 (P <.0001). Student-Newman-Keuls pairwise multiple comparison procedure revealed a statistically significant difference in AUC for control versus superactivated charcoal (P <.05) and for control versus superactivated charcoal-cola (P <.05), but not for superactivated charcoal versus superactivated charcoal-cola (P >.05). Time-concentration curves for the 3 study arms were illustrated graphically.
  
  
  CONCLUSIONS
  Combining superactivated charcoal with cola does not limit the adsorptive capacity of superactivated charcoal.
authors.affiliation: California Poison Control System, San Diego Division, USA. CRANGAN@NEVHC.org
authors.forename: C
authors.initials: C
authors.lastname: Rangan
authors.forename: S P
authors.initials: SP
authors.lastname: Nordt
authors.forename: R
authors.initials: R
authors.lastname: Hamilton
authors.forename: M
authors.initials: M
authors.lastname: Ingels
authors.forename: R F
authors.initials: RF
authors.lastname: Clark
mesh_terms: D000042:Absorption; D000082:Acetaminophen / Q000493:pharmacokinetics*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000493:pharmacokinetics*; D000704:Analysis of Variance; D019540:Area Under Curve; D002253:Carbonated Beverages; D002606:Charcoal / Q000627:therapeutic use*; D018592:Cross-Over Studies; D062787:Drug Overdose / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies
chemical_list: D018712:Analgesics, Non-Narcotic; D002606:Charcoal; D000082:Acetaminophen