Activated charcoal

Active charcoal acts by binding to the pharmaceutical drugs or poisons such as organophosphates and decreasing the systemic absorption of toxic agents. Molecules with large volume of distribution, thus likely having higher lipid solubility, tends to bind have better absorptive binding to activated charcoal. Following the administration of activated charcoal, cathartics are indicated to evacuate the charcoal-poison bonded complex from the gastrointestinal tract. Activated charcoal may also have an effect on systemic drug levels by lowering the serum levels of already absorbed drugs or toxins. Many absorbed drugs that undergo significant hepatic metabolism and conjugation are eliminated via bile into the small intestines. When they reach the small intestines, drug conjugates can undergo hydrolysis and return to the enterohepatic circulation. Activated charcoal interferes with this process and binds to the conjugated drug before hydrolysis or the free deconjugated drug before reabsorption.