SABUTAR

Indications

• Acute poisoning
• Drug overdose
• Gastrointestinal decontamination

Dosage

Children: For children, the usual dose is 1 gram per kilogram of body weight, up to a maximum of 50 grams, administered orally. Always refer to specific guidelines for pediatric dosing.

Adults: The usual adult dose of activated charcoal is 50 to 100 grams administered orally, typically given within one hour of ingestion of the toxin. If the toxin is sustained-release, multiple doses may be required.

Mechanism of action

Activated charcoal works by adsorbing a wide range of drugs and toxins in the gastrointestinal lumen. The porous structure of activated charcoal increases its surface area, allowing it to bind various substances effectively. This prevents absorption through the gastrointestinal tract and facilitates the elimination of the bound substances through fecal excretion.

Pharmacodynamics

Activated charcoal reduces the bioavailability of various medications and toxins by binding them, effectively decreasing their systemic absorption and potential toxicity. The adsorption capacity depends on factors such as surface area, particle size, and the chemical nature of the substance being adsorbed.

Pharmacokinetics

Activated charcoal is not absorbed into the body, and its action is entirely dependent on its adsorption properties in the gastrointestinal tract. It passes through the gastrointestinal system largely unchanged and is eliminated in the feces. Its effects are generally immediate upon administration, and it is typically administered as a single dose unless multiple doses are indicated.

Adverse effects

• Constipation
• Black stools
• Abdominal discomfort
• Nausea

Interactions

• May reduce the absorption of certain medications, including digoxin and warfarin, due to its adsorptive properties

Precautions

• Use with caution in patients with gastrointestinal disorders
• Monitor for potential interactions with medications

Pregnancy

Coal is classified as a category C drug, meaning risk cannot be ruled out. Consult healthcare professionals for advice.

Breast-feeding

Limited information is available; consult healthcare professionals for advice before use.

Storage

Store in a cool, dry place, away from direct sunlight and moisture.

Formulations

• Oral tablets
• Powder
• Suspension

Indications

• Acne vulgaris
• Psoriasis
• Warts
• Seborrheic dermatitis
• Dandruff
• Hyperkeratosis

Dosage

Adults: For topical application, salicylic acid is typically applied once or twice daily, depending on the formulation and condition being treated. Specific dosing guidelines should be followed as per the BNF.

Mechanism of action

Salicylic acid exerts its effects by penetrating the skin and exfoliating the stratum corneum through keratolytic action, which helps in the dissolution of keratin and the removal of dead skin cells. This action facilitates the clearance of pores and can reduce acne lesions. Additionally, salicylic acid has anti-inflammatory properties that can help to decrease swelling and redness associated with various skin conditions. The compound is also known to inhibit the activity of enzymes involved in the synthesis of prostaglandins, which are mediators of inflammation.

Pharmacodynamics

The pharmacodynamics of salicylic acid involve its ability to enhance the turnover of skin cells and reduce the cohesiveness of keratinocytes in the stratum corneum. This leads to increased desquamation and a reduction in the formation of microcomedones in acne. Its anti-inflammatory effects are mediated through the inhibition of cyclooxygenase enzymes, leading to decreased production of pro-inflammatory mediators. This contributes to the reduction of inflammation and pain in affected areas.

Pharmacokinetics

Salicylic acid is absorbed percutaneously when applied topically, with systemic absorption increasing with higher concentrations and prolonged application. Once absorbed, it is metabolized predominantly in the liver to various conjugates, which are then excreted by the kidneys. The elimination half-life can vary based on the formulation and concentration used. For topical applications, significant first-pass metabolism may occur, limiting systemic exposure and reducing potential systemic side effects.

Pregnancy

Salicylic acid is classified as pregnancy category C. Its use should be avoided during pregnancy unless the potential benefits outweigh the risks.

Breast-feeding

Salicylic acid is excreted in breast milk, and caution is advised when using it during breastfeeding.

Storage

Store in a cool, dry place away from direct light.