[Measures to reduce absorption in the treatment of intoxications].
New guidelines on gastrointestinal decontamination in overdose situations have been published. In cases of serious and potentially life-threatening intoxication, gastric lavage can be performed up to 1 hour after ingestion. It should not be considered as routine treatment. If a patient has ingested a potentially toxic amount of a poison which is known to be absorbed by charcoal, single-dose activated charcoal in powder form may be considered up to 1 hour after ingestion. After ingestion of a potentially lethal amount of a toxin that is travelling through the enterohepatic or entero-enteral circulation, multiple-dose activated charcoal can be considered. The efficacy of carbamazepine, theophylline, quinine, dapsone and phenobarbital has been proven. In the treatment of potentially life-threatening intoxications with sustained-release preparations or drug-filled packages, particularly after ingestion of substances that do not bind to activated charcoal, whole bowel irrigation can be considered. Only ifdefaecation is insufficient should administration of a laxative together with activated charcoal be considered.
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Nationaal Vergiftigingen Informatie Centrum van het Rijksinstituut voor Volksgezondheid en Milieu en het Universitair Medisch Centrum Utrecht (UMCU), Postbus 1, 3720 BA Bilthoven.
van Zoelen
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van Riel
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Meulenbelt
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D002400:Cathartics / Q000627:therapeutic use; D002606:Charcoal / Q000627:therapeutic use; D004639:Emetics / Q000627:therapeutic use; D005746:Gastric Emptying / Q000187:drug effects; D005751:Gastric Lavage / Q000379:methods; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D011041:Poisoning / Q000628:therapy*
D002400:Cathartics; D004639:Emetics; D002606:Charcoal