Lapatto-Reiniluoto O, Kivistö K T, Neuvonen P J
Department of Clinical Pharmacology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
Br J Clin Pharmacol. 1999 Aug;48(2):148-53. doi: 10.1046/j.1365-2125.1999.00995.x.
The efficacy of activated charcoal alone, and gastric lavage followed by charcoal in reducing the absorption of diazepam, ibuprofen and citalopram was studied in healthy volunteers.
In a randomized cross-over study with three phases, nine healthy volunteers were administered single oral doses of 5 mg diazepam, 400 mg ibuprofen and 20 mg citalopram, taken simultaneously after an overnight fast. Thirty minutes later, the subjects were assigned to one of the following treatments: 200 ml water (control), 25 g activated charcoal as a suspension in 200 ml water or gastric lavage followed by 25 g charcoal in suspension given through the lavage tube. Plasma concentrations of diazepam, ibuprofen and citalopram were determined up to 10 h.
The AUC(0,10 h) of diazepam was reduced by 27% (P<0.05) by both charcoal alone and charcoal combined with lavage. The increase in plasma diazepam concentration from 0.5 h onwards was prevented by both interventions (P</=0.05), whereas the Cmax of diazepam was not significantly affected by either treatment. The AUC(0, 10 h) of ibuprofen was reduced by 49% (P<0.05) after the combination treatment and by 30% (P<0.05) after charcoal alone, but there was no significant difference between these two treatments. Both charcoal alone and the combination treatment were equally effective in preventing the increase in plasma ibuprofen from 0.5 h onwards (P<0.01). The Cmax of ibuprofen was reduced by 45% (P<0.05) and by 21% (P=NS), respectively. The AUC(0,10 h) of citalopram was reduced by 51% (P<0.05) after both charcoal alone and charcoal combined with lavage, and the Cmax by 52% (P<0.05) and 54% (P<0.05), respectively. The increase in plasma citalopram concentration from 0.5 h onwards was reduced by about 50% (P<0.01) by both interventions.
Activated charcoal alone and charcoal combined with lavage showed similar efficacy in preventing the absorption of diazepam, ibuprofen and citalopram. These results suggest that gastric lavage needs not be routinely performed before administration of charcoal.
在健康志愿者中研究单独使用活性炭以及洗胃后再用活性炭对减少地西泮、布洛芬和西酞普兰吸收的效果。
在一项分三个阶段的随机交叉研究中，9名健康志愿者在禁食过夜后同时口服单剂量的5毫克地西泮、400毫克布洛芬和20毫克西酞普兰。30分钟后，受试者被分配到以下治疗组之一：200毫升水（对照组）、25克活性炭悬浮于200毫升水中，或洗胃后通过洗胃管给予25克活性炭悬浮液。测定地西泮、布洛芬和西酞普兰在长达10小时的血浆浓度。
单独使用活性炭以及活性炭联合洗胃均使地西泮的AUC(0,10 h)降低了27%（P<0.05）。两种干预措施均阻止了地西泮血浆浓度从0.5小时起的升高（P≤0.05），而地西泮的Cmax未受任何一种治疗的显著影响。联合治疗后布洛芬的AUC(0,10 h)降低了49%（P<0.05），单独使用活性炭后降低了30%（P<0.05），但这两种治疗之间无显著差异。单独使用活性炭和联合治疗在阻止布洛芬血浆浓度从0.5小时起升高方面同样有效（P<0.01）。布洛芬的Cmax分别降低了45%（P<0.05）和21%（P=无统计学意义）。单独使用活性炭以及活性炭联合洗胃后西酞普兰的AUC(0,10 h)均降低了51%（P<0.05），Cmax分别降低了52%（P<0.05）和54%（P<0.05）。两种干预措施均使西酞普兰血浆浓度从0.5小时起的升高降低了约50%（P<0.01）。
单独使用活性炭以及活性炭联合洗胃在阻止地西泮、布洛芬和西酞普兰吸收方面显示出相似的效果。这些结果表明在给予活性炭之前无需常规进行洗胃。
