Citation

Van der Werf TS, Bosch TM, Tulleken JE, Ligtenberg JJM, Zijlstra JG. Nederlands Tijdschrift voor Intensive Care 2000; 15(DEC.): 292-298.

Copyright

(Copyright © 2000)

DOI

unavailable

PMID

unavailable

Abstract

Gastric lavage, bowel irrigation, activated charcoal and laxatives, have been advocated to limit resorption of ingested drugs after an overdose. Critical appraisal of the literature reveals hardly any support from rigid clinical trials in patients for most of these measures. Gastric lavage is usually ineffective, especially if applied more than one hour after the overdose. Tricyclic anti-depressants, alcohol and opiates impair gastric emptying, and in case of intoxications with these substances as well as, perhaps, in case of a lithium overdose, gastric lavage still deserves consideration. Activated charcoal (50-100 g in water) is only effective if applied less than one hour after the intoxication; it is ineffective to resorb ionised drugs like lithium. Bowel irrigation using a 5 l watery solution of polyethylene glycol may be useful after lithium and other strongly ionized drugs have been ingested in overdose. The present practice is based on studies in healthy volunteers, while rigid data from clinical trials to support any of the treatment options reviewed here are not available.

Language: en

Keywords

alcohol; article; clinical trial; gastrointestinal absorption; human; intoxication; lithium; macrogol; opiate; self poisoning; stomach lavage; suicide; tricyclic antidepressant agent