A M Rowden1, J E Spoor, J S Bertino. 1. Department of Pharmacy Services, Mary Imogene Bassett Hospital, Cooperstown, New York 13326.
Abstract
STUDY OBJECTIVES: To examine the effect of administration of oral activated charcoal with or without sorbitol on the elimination of phenytoin. SETTING: Emergency department of a rural teaching institution. TYPE OF PARTICIPANTS: Eight normal volunteers. INTERVENTIONS: Subjects received 15 mg/kg phenytoin as an IV infusion. During the first phase of the study, oral activated charcoal was administered to a total dose of 140 g over a ten-hour period. During the second phase of the study, phenytoin alone was administered. MEASUREMENTS AND MAIN RESULTS: Administration of activated charcoal resulted in a significant decrease in the area under the curve 0-inf (p = .008) and in total body clearance (P = .008). No difference in the effect on phenytoin pharmacokinetic parameters was noted when the charcoal was administered with or without sorbitol, but fewer gastrointestinal adverse effects were noted without sorbitol treatment. CONCLUSION: Oral activated charcoal was shown to affect phenytoin pharmacokinetic parameters. Further pharmacokinetic/pharmacodynamic studies are warranted to determine if activated charcoal results in a faster recovery from phenytoin toxicity.
STUDY OBJECTIVES: To examine the effect of administration of oral activated charcoal with or without sorbitol on the elimination of phenytoin. SETTING: Emergency department of a rural teaching institution. TYPE OF PARTICIPANTS: Eight normal volunteers. INTERVENTIONS: Subjects received 15 mg/kg phenytoin as an IV infusion. During the first phase of the study, oral activated charcoal was administered to a total dose of 140 g over a ten-hour period. During the second phase of the study, phenytoin alone was administered. MEASUREMENTS AND MAIN RESULTS: Administration of activated charcoal resulted in a significant decrease in the area under the curve 0-inf (p = .008) and in total body clearance (P = .008). No difference in the effect on phenytoin pharmacokinetic parameters was noted when the charcoal was administered with or without sorbitol, but fewer gastrointestinal adverse effects were noted without sorbitol treatment. CONCLUSION: Oral activated charcoal was shown to affect phenytoin pharmacokinetic parameters. Further pharmacokinetic/pharmacodynamic studies are warranted to determine if activated charcoal results in a faster recovery from phenytointoxicity.