Syrup of ipecac

The most useful household emetic is syrup of ipecac (not ipecac fluid extract, which is 14 times more potent and may cause fatalities). Syrup of ipecac is available in 0.5- and 1-fluid ounce containers (approximately 15 and 30 ml), which may be purchased without prescription. The drug can be given orally, but it takes 15 to 30 min to produce emesis this compares favorably with the time usually required for adequate gastric lavage. The oral dose is 15 ml in children from 6 months to 12 years of age and 30 ml in older children and adults. Because emesis may not occur when the stomach is empty, the administration of ipecac should be followed by a drink of water. 

Asleep, but can be aroused, and can answer questions Semicomatose, withdraws from painful stimuli, reflexes intact 

Comatose, does not withdraw from painful stimuli, no respiratory or circulatory depression, most reflexes intact 

Comatose, most or all reflexes absent, but without depression of respiration or of circulation Comatose, reflexes absent, respiratory depression with cyanosis or circulatory, failure and shock, or both 

Restlessness, irritability, insomnia, tremor, hyperreflexia, sweating, mydriasis, flushing Confusion, hyperactivity, hypertension, tachypnea, tachycardia, extrasystoles, sweating, mydriasis, flushing, mild hyperpyrexia 

---

The most widely used emetic is syrup of ipecac, containing the alkaloids, emetine and cq haeline. Emetine induces vomiting by activation of sensory neurons in the vagus and sympathetic nerves to the stomach and centrally in the medulla, possibly at the CTZ. The release of serotonin and SP may be involved as 5-HT3 and NKi receptor antagonists prevent emesis induced... 

Ms. Jerkins has four children and wants to keep syrup of ipecac available in case of accidental poisoning. Discuss the information you fed that Ms. Jerkins should know before die administers this drug. 

Ingestion Induce vomiting by having victim touch the back of the throat with finger or by giving victim syrup of ipecac as directed do not induce vomiting if victim is unconscious seek medical attention immediately. 

Syrup of ipecac is the method of choice outside the hospital. Do not induce vomiting if the medication is caustic or a petroleum or if the patient is in a coma or having seizures. Syrup of ipecac takes 20 to 30 minutes to work. Consider gastric lavage if response is needed immediately. 

Induce emesis with syrup of ipecac if victim is conscious and has not ingested acids, alkali, hydrocarbons, or petroleum distillates... 

In the U.S., syrup of ipecac has long been valued as an emetic OTC agent in the treatment of poisonings, and it has been the primary form of decontamination in pediatric cases, both at home and in health-care facilities (see Chapter 55). 

During the period from 1983 to 1991 there has been a continual decline in the use of syrup of ipecac to induce emesis. Ipecac contains a number of plant alkaloids including emetine. It induces emesis through stimulation of the chemoreceptor trigger zone in the brain and local irritation of the gastrointestinal tract. The latency period for... 

Syrup of ipecac (use to induce vomiting if advised by the poison control center)... 

Emesis with syrup of ipecac has been reeommended for children with a history of accidental ingestion of small amounts, more than a grain or two , if it ean be administered within 1 h from the time of ingestion (Katona and Wason, 1989). 

Put a finger or the blunt end of a spoon at the back of victim s throat or give the victim syrup of ipecac. 

Krenzelok EP, Freedman GE, Pasternak S. Preserving the emetic effect of syrup of ipecac with concurrent activated charcoal administration a preliminary study. J Toxicol Chn Toxicol 1986 24(2) 159-66. 

Syrup of ipecac (purging solution) and gastric lavage should be administered within 4-6 h of oral exposure to arsenic. Antidotes include 3-5 mg kg BAL (2,3-dimercaptopropanol) administered intramuscularly. Penicilamine has also been administered with optical neuritis as a side effect. Certain synthetic, water-soluble dimercapto compounds (DMSA - meso-2, 3-dimercaptosuccinic acid and 2,3-dimercaptopro-pane-l-sulfonate) have been found effective. 

---