Talk:Activated charcoal (medication)

Heading

So this article says that there is no evidence that activated charcoal improves poisoning outcomes, but then at the bottom lists the mechanisms in which it treats poisonings and mentions that it's on the WHO list of essential medications, so what the heck? It can't be both ways. 47.54.240.84 (talk) 18:44, 24 December 2015 (UTC)

It says "no good evidence". This means no RCTs in humans. There is theoretical evidence. So yes it can be both ways. Best Doc James (talk · contribs · email) 22:55, 24 December 2015 (UTC)

The source article says "routine administration in poisoned patients is not recommended by American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists (AACT/EAPCCT).113 Controlled studies demonstrating reduced morbidity and mortality generally are lacking." I'm pretty sure evidence is lacking specifically for the effectiveness of routine treatment. It seems clear to me that single treatments in the case of acute poisoning are considered effective. I think someone made a mistake writing this article. Lolbifrons (talk) 09:30, 20 February 2016 (UTC)

Yes, "no good evidence" is a sloppy way of summarizing the source. I've edited the article. Marfire (talk) 06:19, 16 May 2016 (UTC)

Doc James, could you please justify your reversion of my edit? Your preferred summary of "no good evidence" is clearly not supported by the cited source, whereas my summary closely matched the actual text. As others have pointed out, the caveats on that page refer to its routine administration, which is clear if you look at the papers that it cites to support that statement. The general claim that scientific evidence can be divided into "good" and "bad" based on whether it's from a RCT is both not true and not implied by the cited source. Marfire (talk) 21:17, 16 May 2016 (UTC)

THe "no good evidence" is based on "Controlled studies demonstrating reduced morbidity and mortality generally are lacking". This applies to all use not just routine use.

How about "there is no good evidence that it improves outcomes and routine use is not recommended"? Controlled RCTs are the usual standard for treatments. Doc James (talk · contribs · email) 23:01, 16 May 2016 (UTC)

There are many kinds of studies and much "good" evidence that does not come from RCTs, especially in areas where conducting RCTs would be unethical (like, say, poisonings?). Dismissing all such evidence as "not good" is very overbroad, and here it constitutes editorializing.

If you look at the papers cited in support of the statement you quoted, you will see that they do not support your interpretation. The "state-of-the-art review", for example, says: "The use of activated charcoal in these cases may be beneficial and is associated with few complications." The other paper says: "Based on volunteer studies, the administration of activated charcoal may be considered if a patient has ingested a potentially toxic amount of a poison (which is known to be adsorbed to charcoal) up to one hour previously." So a distinction is being drawn between routine use and use in specific cases where the evidence is indeed "good", or at least good enough to guide clinical practice as decided by experts in the field.

If you think it's important to communicate the dearth of controlled studies, then I suggest something like (hewing close to the source): "Although controlled studies of its effectiveness in oral poisonings are lacking, there is some evidence of its effective use with specific poisons, especially when applied soon after ingestion." Marfire (talk) 12:30, 17 May 2016 (UTC)

Yes good point, have specified RCTs. Doc James (talk · contribs · email) 17:58, 17 May 2016 (UTC)

Even with all these little tweaks and clarifications, it's still very easy to read this article and walk away having learned three key points:

1. Activated charcoal theoretically works by adsorbing poisons, preventing their uptake into the blood.
2. Activated charcoal is widely used in the treatment of poisons.
3. Activated charcoal is not actually useful in the treatment of poisons.

It reads like a carefully-written article about acupuncture or something, not an article about a WHO essential medicine. -165.234.252.11 (talk) 18:02, 28 July 2016 (UTC)

I agree, it's confusing. My understanding is that it would be unethical to conduct RCTs for acute poisoning cases, and that's what activated charcoal is for, so why even mention the lack of RCTs? It's like saying that your bicycle has not passed any emissions tests: A technically true statement, but not one that conveys useful information, since nobody does emissions tests on bicycles. Dausuul (talk) 01:34, 17 July 2017 (UTC)

We are actually moving more and more away from routine use of activated charcoal in poisoning.

It is now only recommended if 1) the person has a normal LOC 2) the person presents within an hour of exposure 3) the person has taken a significant amount of a potentially serious toxin

It is not to be used just because we always use it or to punish the patient. Doc James (talk · contribs · email) 05:43, 17 July 2017 (UTC)

Side effect

In "Side effects": Medication to treat stomach ache formulated with activated charcoal increases blood flow to the stomach in order to alleviate pain How does activated charcoal increase blood flow? Citation? --92.214.155.145 (talk) 16:49, 25 September 2016 (UTC)

Removed that [1] Doc James (talk · contribs · email) 04:26, 26 September 2016 (UTC)

Move discussion in progress

There is a move discussion in progress on Talk:Lithium (medication) which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 23:15, 28 January 2019 (UTC)

I'm wondering if following statement is right

"Gastrointestinal obstruction and ileus are less common but serious adverse effects." The wordings seem to me vague, and as I refer to the citation, it says "and GI obstruction or fecal impaction in dehydrated patients", but it seems to be no nomentioning of author's description. I could be wrong, and would invite anybody to enlighten me. Thank you. ThomasYehYeh (talk) 01:17, 5 March 2024 (UTC)