The effect of ethanol and pH on the adsorption of acetaminophen (ACET), phenobarbital (PHB), phenytoin (PHY), salicylic acid (SA), and theophylline (THEO) from simulated gastric fluid onto activated charcoal was studied. For the ethanol study, each drug was prepared at a concentration of 10 g/L in ethanol; in hydrochloric acid (HCl), 1.2 mol/L; and in HCl, 1.2 mol/L, containing 75% ethanol, 50% ethanol, and 25% ethanol (v/v), respectively. For the pH study, each drug was prepared at a concentration of 10 g/L in HCl, 1.2 mol/L, pH 1.0, and in buffers of pH 1.7, 3.0, 4.0, 4.8, 5.8, 6.5, 7.4, and 9.4. After the addition of 1 g of activated charcoal to 10 mL of each solution, it was incubated for one hour at 37 °C. For comparison, in each experiment a blank consisting of the solution without charcoal was also incubated. With increasing concentrations of ethanol, there were substantial decreases in the adsorption of ACET, PHB, and PHY to charcoal. Ethanol-induced decreases in the adsorption of SA and THEO were less pronounced. Changes in pH did not affect the adsorption of ACET, PHB, PHY, or THEO. However, the adsorption of SA was decreased slightly at pH 1.0 and 3.0.
Drug overdose frequently involves the co-ingestion of ethanol as well as a variety of other drugs and substances (1), each of which may have the potential of altering the pH of gastric fluid. While there is a substantial literature on the effect of ethanol and pH on drug adsorption to charcoal (2–5), most published reports have generally focused on only one drug (2), one ethanol concentration (2,3), or only two pHs (2,3).
This study was undertaken to determine the effects of various ethanol concentrations and ranges of pH on the adsorption of several widely used drugs from simulated gastric fluid to activated charcoal since this agent is often used in the immediate treatment of acute drug overdose (6).