Activated charcoal is effective in decreasing absorption of pesticides by binding these on the surfaces of the charcoal particles. Activated charcoal is not systemically absorbed.
In performing lavage, ensure that the patient is in Trendelenburg and left lateral decubitus position.
To produce effective adsorption, a ratio of about 10 parts charcoal to 1 part poison is needed.
             Adult: 50-100 g of activated charcoal in 200 mL water
             Pedia: 1 g/kg or 30-50 g in 100 mL water
Multiple doses of activated charcoal lavage are helpful in the management of poisoning with pesticides which undergo enterohe-patic recirculation such as organochlorines and paraquat. These can be given every 6-8 hours. Caution must be exercised during administration because of the danger of intestinal impaction. Subsequent doses may thus be reduced to half the initial dose.
Activated charcoal lavage should be followed by sodium sulfate cathartics. It is contraindicated in co-ingestion of caustics.

Demulcents/ Cathartics
Raw egg albumin only - a commonly used demulcent.
          Adult: 8-12 eggs
          Pedia: 4-6 eggs
Cathartics can be used to hasten intestinal elimination of the unabsorbed toxic agent. Little information is available regarding the efficacy of cathartics when used alone following poisoning.
Cathartics are contraindicated in co-ingestion of caustics, in patients with paralytic ileus, severe fluid and electrolyte disturbances, and extremes of age. Sodium-containing cathartics are contraindicated in patients with congestive heart failure. Magnesium- or phosphate-containing cathartics are contraindicated in patients with bowel disorders, renal impairment and CNS depression (grades 3 and 4 )
Sodium sulfate
           Adult: 15 g in 100 mL water
           Pedia: 250 mg/kg given as 10% solution
Sodium sulfate should be administered after charcoal lavage. If no bowel movement occurs in 30 minutes to 1 hour, another dose may be given. If still no bowel movement occurs, do not give another dose of the sodium sulfate. Consider giving soap sud enema instead.