Makosiej F J, Hoffman R S, Howland M A, Goldfrank L R
New York City Poison Control Center, NY 10016.
J Toxicol Clin Toxicol. 1993;31(3):381-95. doi: 10.3109/15563659309000407.
Cocaine body-packers and body-stuffers have become a common medical problem. Significant morbidity and mortality result when cocaine is absorbed from the gastrointestinal tract due to cocaine package compromise. The clinical prevention of gastrointestinal absorption of cocaine includes oral activated charcoal and/or whole bowel irrigation with polyethylene glycol--electrolyte lavage solution. This in vitro study investigates the maximal adsorptive capacity of activated charcoal for cocaine at varying activated charcoal:cocaine ratios, at pH 1.2 and pH 7.0, and the effect of polyethylene glycol--electrolyte lavage solution upon this binding. The percent adsorption of cocaine to activated charcoal was significantly better at pH 7.0 for all ratios of activated charcoal:cocaine tested and the maximal adsorptive capacity was 29% greater at pH 7.0 (273 micrograms/mg) than at pH 1.2 (212 micrograms/mg) (p < 0.05). Addition of polyethylene glycol--electrolyte lavage solution to the cocaine-activated charcoal slurry caused significant desorption of cocaine from activated charcoal at all pHs and ratios tested (except the 1:1 ratio at pH 7.0) and was most pronounced at pH 1.2. The addition of polyethylene glycol--electrolyte lavage solution to activated charcoal prior to adding cocaine solution further decreased the adsorption of cocaine to activated charcoal. This difference was significant at both pHs and all ratios tested except the 1:1 ratio at pH 1.2. The maximal adsorptive capacity of activated charcoal for cocaine at pH 1.2 was reduced 75% by pretreatment with polyethylene glycol--electrolyte lavage solution from 212 to 54.2 micrograms/mg, while at pH 7.0 the maximal adsorptive capacity was reduced by 11%, from 273 to 243 micrograms/mg. Polyethylene glycol--electrolyte lavage solution significantly reduces the adsorption of cocaine to activated charcoal particularly if the two are combined at a low pH prior to the addition of cocaine. The in vitro effects suggest that activated charcoal mixed in water should be administered first, followed by the polyethylene glycol--electrolyte lavage solution.
体内藏毒（可卡因）者已成为一个常见的医学问题。当可卡因包装破裂导致其从胃肠道吸收时，会引发严重的发病率和死亡率。预防可卡因胃肠道吸收的临床方法包括口服活性炭和/或用聚乙二醇 - 电解质灌洗液进行全肠道灌洗。这项体外研究调查了在不同的活性炭与可卡因比例、pH值为1.2和pH值为7.0的情况下，活性炭对可卡因的最大吸附能力，以及聚乙二醇 - 电解质灌洗液对这种结合的影响。对于所有测试的活性炭与可卡因比例，在pH值为7.0时，可卡因对活性炭的吸附百分比明显更好，且在pH值为7.0时的最大吸附能力（273微克/毫克）比在pH值为1.2时（212微克/毫克）高29%（p < 0.05）。在所有测试的pH值和比例下（pH值为7.0时的1:1比例除外），向可卡因 - 活性炭浆液中添加聚乙二醇 - 电解质灌洗液会导致可卡因从活性炭上显著解吸，且在pH值为1.2时最为明显。在添加可卡因溶液之前，先向活性炭中添加聚乙二醇 - 电解质灌洗液会进一步降低可卡因对活性炭的吸附。除了pH值为1.2时的1:1比例外，在所有测试的pH值和比例下，这种差异都很显著。在pH值为1.2时，用聚乙二醇 - 电解质灌洗液预处理后，活性炭对可卡因的最大吸附能力从212微克/毫克降至54.2微克/毫克，降低了75%，而在pH值为7.0时，最大吸附能力从273微克/毫克降至243微克/毫克，降低了11%。聚乙二醇 - 电解质灌洗液显著降低了可卡因对活性炭的吸附，特别是如果在添加可卡因之前，将两者在低pH值下混合。体外实验结果表明，应先给予溶于水的活性炭，然后再给予聚乙二醇 - 电解质灌洗液。
