Renzi F P, Donovan J W, Martin T G, Morgan L, Harrison E F
Ann Emerg Med. 1985 Jun;14(6):568-72. doi: 10.1016/s0196-0644(85)80781-2.
Activated charcoal is a safe, effective, inexpensive adjunct in the management of most toxic ingestions. It has the ability to adsorb a wide variety of drugs and chemicals, one of which is acetaminophen. N-acetylcysteine (NAC) is the specific antidote available for serious overdoses of acetaminophen. Current management of acetaminophen overdose, however, does not recommend the concomitant oral administration of these two useful agents because adsorption and inactivation of NAC by charcoal is believed to occur. Our study was designed to help evaluate the effect of activated charcoal on N-acetylcysteine absorption. Ten healthy male volunteers were each given in the first, or control, phase of the study an oral dose of 140 mg/kg NAC, and venous blood samples were obtained. In the second phase, after a washout period, each subject received 60 g activated charcoal orally followed immediately by 140 mg/kg NAC. NAC serum levels were measured using gas-liquid chromatography, and levels were compared with and without the concomitant administration of charcoal. Although only a small number of the subjects completed the study, the results showed that in both phases there were no significant differences in the peak NAC levels, the plasma half-life of NAC, or the calculated area under the curve. We recommend that NAC and activated charcoal not be used clinically until further studies are completed.
活性炭是处理大多数中毒性摄入时一种安全、有效且廉价的辅助手段。它能够吸附多种药物和化学物质，对乙酰氨基酚就是其中之一。N - 乙酰半胱氨酸（NAC）是用于对乙酰氨基酚严重过量中毒的特效解毒剂。然而，目前对乙酰氨基酚过量中毒的处理并不推荐同时口服这两种有用的药物，因为据信活性炭会吸附并使NAC失活。我们的研究旨在评估活性炭对N - 乙酰半胱氨酸吸收的影响。在研究的第一阶段，即对照阶段，10名健康男性志愿者每人口服140 mg/kg的NAC，并采集静脉血样。在第二阶段，经过洗脱期后，每位受试者口服60 g活性炭，随后立即口服140 mg/kg的NAC。使用气液色谱法测量NAC血清水平，并比较同时给予活性炭和未给予活性炭时的水平。尽管只有少数受试者完成了研究，但结果表明在两个阶段中，NAC的峰值水平、NAC的血浆半衰期或计算出的曲线下面积均无显著差异。我们建议在完成进一步研究之前，临床上不要同时使用NAC和活性炭。
