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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of ipecac syrup as an emetic in adults as well as children who had ingested antiemetics or other drugs was evaluated. Adults or children over five years of age were given 30 ml of ipecac syrup followed by 360 ml of water; children aged one to five years were given 15 ml ipecac syrup followed by 240 ml of water. If emesis was not induced within 30 minutes, a second dose was administered. Of 232 patients studied (199 adults and 33 children), 188 (81%) vomited following the first dose, 34 (15%) required two doses and seven (3%) did not vomit. Of 63 patients who had ingested drugs with antiemetic properties, 51 (81%) vomited following the first dose, nine (14%) required a second dose and three (5%) did not vomit. The time from ipecac administration to the onset of emesis in all 232 patients averaged 24.2 minutes. Ipecac was successful in inducing rapid emesis in both adults and children who had ingested antiemetics or other drugs, probably as a result of its irritating effect on the gastric mucosa.
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PMID:Rapid emesis from high-dose ipecac syrup in adults and children intoxicated with antiemetics or other drugs. 3 Feb 80

This report describes a toddler with chronic diarrhea, vomiting, and hypotonia due to surreptitious administration of syrup of ipecac by his mother (Munchausen's syndrome by proxy). Several features of this case distinguish it from previous reports of chronic ipecac ingestion in childhood: the development of grossly bloody stools; radiologic, endoscopic, and biopsy evidence of a chronic moderate colitis resembling ulcerative colitis; and the histologic finding of pseudomelanosis coli, providing an important clue to toxic ingestion. The significance and possible mechanism for genesis of pseudomelanosis coli is discussed. This case emphasizes the variability in presentation and difficulty in diagnosing long-term ipecac ingestion by proxy. Ipecac toxicity should be considered in children with unexplained colitis and vomiting.
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PMID:Hemorrhagic colitis and pseudomelanosis coli in ipecac ingestion by proxy. 167 9

As in all medical emergencies, in acute poisoning the cornerstone of management is good supportive care. Aggressive support of the cardiovascular, respiratory, and central nervous systems, along with appropriate gastric decontamination, greatly reduces morbidity and mortality and improves patient outcome. Ipecac is generally reserved for home use, where it can be given to induce emesis immediately after ingestion of toxins, and it is given only in cases of mild or moderate toxicity. Activated charcoal should replace ipecac in the emergency department for cases of mild or moderate toxicity. Gastric lavage and administration of activated charcoal should be considered in cases with life-threatening potential. A cathartic should be considered after activated charcoal has been administered, but only in cases where it will not have a detrimental effect.
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PMID:Acute poisoning emergencies. Resolving the gastric decontamination controversy. 173 38

Acute poisoning remains a common cause of morbidity and even mortality in children and adults. The goal of gastrointestinal decontamination is to eliminate or to reduce the potentially life-threatening effects of the ingested poison. Methods of gastrointestinal detoxication in case of acute poisoning, such as induced emesis, gastric lavage, administration of activated charcoal and intestinal cleansing are discussed. As far as induced emesis is still concerned, only the administration of Ipecac-syrup can be retained. The controversy between emesis and gastric lavage still remains. For those toxins well adsorbed by activated charcoal, the administration of activated charcoal, followed or not by gastric lavage, is the treatment of choice. Single doses of activated charcoal can be insufficient. In certain kinds of poisoning, repeated doses of activated charcoal are advisable because of the interruption of the entero-hepatic and entero-enteric circulation. The benefit and the indications for intestinal cleansing in case of acute poisoning seem to be very limited.
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PMID:Gastrointestinal decontamination for acute poisoning. 197 55

The emetic agent ipecac is widely used for the initial treatment of acute oral drug overdose. Its emetic and gastric evacuative efficacies have been studied extensively but its potential for pharmacologic interactions with various drugs and other possible poisons has not been explored. The purpose of this investigation was to determine if ipecac can alter the acute toxicity of two widely used drugs that act on the central nervous system, phenobarbital and theophylline. Ipecac syrup, 5 ml/kg, was administered by gavage to male Lewis rats either 1 hr before or 15 or 30 min after the start of an iv infusion of phenobarbital or theophylline. Control animals received the syrup vehicle only. Ipecac elicited vomiting-like behavior (frequent, wide opening of the mouth) for more than 1 hr. The drug infusion was stopped immediately after onset of the loss of righting reflex (phenobarbital) or maximal seizures (theophylline). Samples of cerebrospinal fluid, blood (for serum), and the brain were obtained at that time for analysis of drug concentrations. There were no significant differences between control and ipecac-treated animals with respect to the dose requirements and drug concentrations in cerebrospinal fluid, serum, and brain at the respective pharmacologic endpoint. It is concluded that ipecac has no apparent effect on the acute toxicity of phenobarbital and theophylline in rats.
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PMID:Systemic effect of ipecac on acute toxicity of phenobarbital and theophylline in rats. 257 54

Retail pharmacists should recognize their inadequate knowledge of Ipecac instructions. When confronted with an acute poisoning, these patients should be referred to their physician or nearest regional poison control center (3). Providing improper instructions creates the risks of: Vomiting a substance with which emesis is contraindicated; Unnecessary emesis; and Use of ineffective and unsafe methods of inducing emesis. Only 2 (6.25%) pharmacists gave complete and accurate instructions for the use of Ipecac--with the exception of mentioning the contraindications to emesis. However, both pharmacists referred the caller to their regional poison control center.
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PMID:Ask your pharmacist? 286 28

Ipecac-induced emesis and gastric lavage are the two procedures most widely used to evacuate the stomachs of patients who have ingested poisons. To resolve a long-standing controversy over the relative efficacy of these two methods, the authors carried out a controlled study in which they administered 25 100-micrograms tablets of cyanocobalamin (vitamin B12) to 18 fasting normal adult volunteers on two separate days. On one day, each subject had emesis induced with 30 ml of ipecac syrup followed by 1,000 ml of tap water; on another day, each underwent gastric aspiration and lavage with a 1.1-cm orogastric tube using 3 l of fluid. Both procedures were begun 10 minutes after the ingestion. The recovered vomitus or gastric washings from each procedure were then analyzed for elemental cobalt using atomic absorption spectrophotometry. The mean rate of recovery of the ingested tracer with ipecac-induced emesis was only 28%, whereas gastric lavage resulted in retrieval of 45% (paired t-test, P less than 0.005). In this study, carefully performed gastric lavage was the more effective method of gastric evacuation of tablets in the adult subject.
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PMID:Ipecac-induced emesis versus gastric lavage: a controlled study in normal adults. 287 Jul 22

Ipecac abuse among bulimics is being increasingly reported. The case presented is a 19-year-old female with significant eating-related problems, including frequent binges and daily use of ipecac to induce vomiting. Medical evaluation revealed significant muscle weakness, cardiac impairment, and altered levels of serum enzymes. The physical debilitation caused by the ipecac use dissipated following apparent discontinuation of ipecac ingestion. The symptom presentation and management problems in this case are discussed to alert clinicians involved in consultation about ipecac abuse.
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PMID:Ipecac abuse: a serious complication in bulimia. 288 67

Ipecac (emetine) is a safe emetic for emergency home use. Its ready availability also provides the potential for child abuse and chronic self-induced emesis. The chronic administration of Ipecac can result in unusual symptom complexes such as chronic diarrhea and vomiting, muscle weakness, colitis, cardiomyopathy, fever, edema, or electrolyte disturbances. We describe patients who were intentionally poisoned and who demonstrated these symptoms. Because of the widespread use of ipecac for therapy in acute accidental poisonings, toxicology laboratories may not look for or report the presence of this drug in their routine screens. This may delay the recognition of chronic ipecac poisoning in patients.
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PMID:Intentional ipecac poisoning in children. 289 58

Inability to vomit has been cited as characteristic of Prader-Willi syndrome (PWS). Although post-prandial vomiting after gastric by-pass surgery has been reported, neither vomiting under "typical" circumstances or rumination have been described. Prompted by the discovery of several cases of vomiting and rumination, a questionnaire was sent to members of the PWS Association. Approximately 36% (113/313) of affected individuals reportedly experienced at least one episode of vomiting. Induced vomiting was unsuccessful in 9 of 14 cases in whom results were known. However, no complications of Ipecac were reported. We suggest that there is an alteration in the physiologic set-point at which vomiting occurs, leading to a decreased propensity to vomit. Liberal and strict definitions of rumination yielded 15.7% and 10.2% positive responses, respectively. Rumination was associated with a history of vomiting. Enamel deterioration consistent with rumination has been observed, and such changes should be looked for in all PWS children. In several instances, rumination was found to decrease when very strict weight control was lessened. Certain individuals may ruminate under too strict a weight control program, and weight control goals should be evaluated to achieve a reasonable compromise between ideal weight and obesity. Vomiting and rumination do not rule out the diagnosis of PWS.
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PMID:Rumination and vomiting in Prader-Willi syndrome. 368 27


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