Acute acetaminophen poisoning in children: kids aren't just little adults

Comparative study of the adsorption of acetaminophen on activated carbons in simulated gastric fluid

Samples of commercial activated carbons (AC) obtained from different sources: Norit E Supra USP, Norit B Test EUR, and ML (Baracoa, Cuba) were investigated. The adsorption of acetaminophen, Co = 2500 mg/L, occured in simulated gastric fluid (SGF) at pH 1.2 in contact with activated carbon for 4 h at 310 K in water bath with stirring. Residual acetaminophen was monitored by UV visible. The results were converted to scale adsorption isotherms using alternative models: Langmuir TI and TII, Freundlich, Dubinin-Radushkevich (DR) and Temkin. Linearized forms of the characteristic parameters were obtained in each case. The models that best fit the experimental data were Langmuir TI and Temkin with R(2) ≥0.98. The regression best fits followed the sequence: Langmuir TI = Temkin > DR > LangmuirTII > Freundlich. The microporosity determined by adsorption of CO2 at 273 K with a single term DR regression presented R(2) > 0.98. The adsorption of acetaminophen may occur in specific sites and also in the basal region. It was determined that the adsorption process of acetaminophen on AC in SGF is spontaneous (ΔG <0) and exothermic (-ΔHads.). Moreover, the area occupied by the acetaminophen molecule was calculated with a relative error from 7.8 to 50%.

The effect of yogurt on acetaminophen absorption by activated charcoal and burnt toast

Although acetaminophen overdose can be treated with N-acetylcysteine, activated charcoal is useful in preventing absorption of acetaminophen from the gut. Mixing activated charcoal with yogurt may make the dose more palatable. We investigated effects of yogurt on absorption of acetaminophen by burnt toast or activated charcoal in intestinal fluid using an in vitro model. The aliquots of phosphate buffer saline (PBS) were supplemented with high concentrations of acetaminophen after adjusting the pH to 7.2 (to mimic intestinal fluid). Then specimens were treated with various dosages (15 mg/mL, 25 mg/mL, or 50 mg/mL) of activated charcoal or burnt toast. A small amount of fluid was withdrawn at 0, 5, 10, 20, and 30 min and acetaminophen concentrations were measured by the fluorescence polarization immunoassay (FPIA). We also treated other aliquots of PBS buffer containing acetaminophen with activated charcoal and yogurt or burnt toast and yogurt. Then small aliquots were withdrawn at specific time intervals to determine concentrations of acetaminophen. Activated charcoal was very effective in removing acetaminophen from intestinal fluids and the presence of yogurt insignificantly affected such absorptions. In contrast, burnt toast had a modest effect on removing acetaminophen from fluids but yogurt significantly increased the capability of burnt toast to absorb acetaminophen. However, the activated charcoal/yogurt combination is more effective than the burnt toast/yogurt combination for absorbing acetaminophen.