PEDIATRICS Vol. 80 No. 3 September 1987, pp. 364-367
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Amitai, Y.
Right arrow Articles by Lovejoy, F. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Amitai, Y.
Right arrow Articles by Lovejoy, F. H., Jr

Ipecac-Induced Emesis and Reduction of Plasma Concentrations of Drugs Following Accidental Overdose in Children

Yona Amitai MD1, Allen A. Mitchell MD1, Michael A. McGuigan MD1, and Frederick H. Lovejoy Jr MD1

1 From the Division of Clinical Pharmacology and Toxicology, The Children's Hospital; The Department of Pediatrics, Harvard Medical School; The Massachusetts Poison Control System, Boston, and The Hospital for Sick Children, Toronto

Syrup of ipecac is widely used following accidental drug overdosage in children. Proof of its efficacy, however, in reducing the risk of poisoning is limited. We prospectively studied the effect of early v late induction of emesis by ipecac in 50 children younger than 5 years of age with accidental acetaminophen poisoning. The mean estimated ingested dose was 165 mg/kg, and all patients vomited within 15 to 255 (mean 78) minutes postingestion. Although the predicted four-hour plasma acetaminophen concentration was 97 ± 4 µg/mL (mean ± SEM, calculated on the basis of the estimated ingested dose), the measured four-hour plasma acetaminophen concentration was 34 ± 5 µg/mL (P < .01). To assess the efficacy of early v late ipecac-induced emesis, we used the ratio of measured to predicted four-hour acetaminophen plasma concentration. The ratio of the measured to predicted four-hour level increased as the delay in time to vomiting increased (r = .60, P < .001). Ipecac syrup was administered more promptly when available in the home than when obtained from a pharmacy or a medical facility (26 ± 8 v 83 ± 13 minutes postingestion, respectively; P < .001) and vomiting occurred earlier (49 ± 9 v 103 ± 12 minutes postingestion; P < .01). Although the mean estimated doses ingested were greater in patients who received ipecac syrup at home, their four-hour plasma acetaminophen concentrations were lower. These data suggest that prompt administration of ipecac syrup results in a greater reduction in plasma acetaminophen concentrations in potentially toxic overdosages in children. Further availability of ipecac syrup at home facilitates its prompt use.

Key Words: ipecac syrup • acetaminophen overdosage • emesis

Submitted on July 17, 1986
Accepted on October 28, 1986




This article has been cited by other articles:


Home page
 PediatricsHome page
Committee on Injury, Violence, and Poison Preventi
Poison Treatment in the Home
Pediatrics, November 1, 2003; 112(5): 1182 - 1185.
[Abstract] [Full Text] [PDF]