Syrup of Ipecac
Emetic
Syrup of Ipecac acts as a local irritant on the gastric mucosa and on emetic centers of the brain. Vomiting induced by syrup of Ipecac occurs in 80-90% of patients. The drug is available over-the-counter, however, medical direction and/or a poison control center should be consulted prior to administration.
Generally, 15-20 minutes
80 minutes
Acute oral drug or toxin overdose in alert patients
Caustics, corrosives, petroleum distillates
Unprotected airways
Absent gag reflex
Unknown ingestion
Children less than 1 year of age
Rapidly acting CNS depressants (Causing decreased level of consciousness faster than ipecac can work)
Prolonged vomiting
Muscle aching, weakness
Cardiac conduction disturbances/dysrhythmias
Chest pain
Hypotension
Activated charcoal adsorbs ipecac
15,30 ml vials
30 ml PO followed by 2-3 glasses of water; may repeat once in 20 minutes if ineffective.
15 ml PO followed by 2-3 glasses of water; may repeat once in 20 minutes if ineffective.
Pregnancy Safety: Not established
Do not administer to children less than 1 year old.
Carefully monitor patient’s airway
90% of patients vomit within one-half hour of administration (average time is 20 min)
Activated charcoal should be administered only after vomiting has occurred.
A disadvantage of syrup of ipecac is that persistent vomiting may preclude use of activated charcoal.
Save emesis sample for evaluation
Patients usually vomit 2-3 times per dose over 1-2 periods. Keep patient awake.
Administer with caution in TCA overdoses as they may rapidly progress to seizures and unconsciousness (within 30 minutes); ipecac should not be given unless OD was witnessed, such as acetaminophen witnessed by parent.