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Syrup of Ipecac

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21. Toxicity, Cocaine (Treatment)

been ingested (not as part of body packing or body stuffing), the patient without altered mental status may be treated by administration of activated aqueous charcoal. Gastric lavage and induction of vomiting via ipecac syrup are not recommended because of the risk of seizure, with the potential for airway compromise and aspiration of vomitus. Previous Next: Body Packing and Body Stuffing In body packers, although a risk for toxicity exists, the drugs are often carefully packaged to prevent rupture

2014 eMedicine.com

22. Toxicity, Barbiturate (Treatment)

of a few specific antidotes has decreased the mortality rate in unselected overdose patients to less than 1% if the patient arrives at the hospital in time for the clinician to intervene. [ ] Although multiple doses of activated charcoal (MDAC) have been shown to enhance elimination of phenobarbital and to reduce the serum half-life, a definite improvement in clinical outcome has not been shown in any studies using MDAC. Induction of emesis with ipecac syrup is contraindicated in these patients because

2014 eMedicine.com

23. Toxicity, Iron (Overview)

Toxicol (Phila) . 2018 Dec 21. 55 (10):1-203. . . [Guideline] Höjer J, Troutman WG, Hoppu K, Erdman A, Benson BE, Mégarbane B, et al. Position paper update: ipecac syrup for gastrointestinal decontamination. Clin Toxicol (Phila) . 2013 Mar. 51(3):134-9. . Tenenbein M. Benefits of parenteral deferoxamine for acute iron poisoning. J Toxicol Clin Toxicol . 1996. 34(5):485-9. . Sankar J, Shukla A, Khurana R, Dubey N. Near fatal iron intoxication managed conservatively. BMJ Case Rep . 2013 Jan 31. 2013

2014 eMedicine.com

24. Toxicity, Iron (Treatment)

(10):1-203. . . [Guideline] Höjer J, Troutman WG, Hoppu K, Erdman A, Benson BE, Mégarbane B, et al. Position paper update: ipecac syrup for gastrointestinal decontamination. Clin Toxicol (Phila) . 2013 Mar. 51(3):134-9. . Tenenbein M. Benefits of parenteral deferoxamine for acute iron poisoning. J Toxicol Clin Toxicol . 1996. 34(5):485-9. . Sankar J, Shukla A, Khurana R, Dubey N. Near fatal iron intoxication managed conservatively. BMJ Case Rep . 2013 Jan 31. 2013: . Carlsson M, Cortes D, Jepson S (...) texture and may be difficult to remove by lavage. Whole-bowel irrigation may be used in patients with a radiopacity on kidneys, ureters, bladder (KUB) plain radiographs, until the radiopacity clears. Ipecac has been used for gastric decontamination in patients with iron poisoning. Ipecac might be considered when it can be administered within 60 minutes of iron ingestion, in an alert patient who has ingested a very large amount of iron. Ipecac is not used routinely for iron removal because it can mask

2014 eMedicine Emergency Medicine

25. Toxicity, Disulfiram (Treatment)

emesis and third spacing of intravascular fluid. Intravenous fluids and vasopressors are indicated to support blood pressure and treat patients who are in shock. Decontamination procedures are not likely to be beneficial once the reaction begins. Consider gastric emptying only in the hospital setting with cases of massive ethanol ingestion in which a patent and protected airway can be maintained. Inducing emesis with ipecac syrup is not recommended. Ipecac syrup contains ethanol, which could

2014 eMedicine Emergency Medicine

26. Toxicity, Ciguatera (Treatment)

== processing > Ciguatera Toxicity Treatment & Management Updated: Dec 29, 2015 Author: Thomas C Arnold, MD, FAAEM, FACMT; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Ciguatera Toxicity Treatment Approach Considerations Treatment is largely supportive and symptom driven. If performed within 3-4 hours of toxin ingestion, gastric decontamination with activated charcoal may help. Avoid administering ipecac syrup because of its potential to worsen fluid losses. Antiemetics

2014 eMedicine Emergency Medicine

27. Toxicity, Clonidine (Treatment)

is present on the skin, remove it and wash the exposed area. Initiate standard naloxone therapy and blood glucose checks. Continuous electrocardiographic (ECG) monitoring should carry over to the emergency department (ED). Prehospital ipecac syrup administration is contraindicated. Next: Emergency Department Care Focus initial treatment on the ABCs. Clonidine toxicity can cause serious respiratory depression and apnea requiring immediate endotracheal intubation and mechanical ventilation. Once the airway

2014 eMedicine Emergency Medicine

28. Toxicity, Cyclic Antidepressants (Treatment)

should be avoided in patients with CA toxicity: The use of physostigmine in CA poisoning has been associated with complete heart block, asystole, and hypotension Ipecac syrup is not recommended as the procedure in GI decontamination because of the possibility that patients experience sudden neurologic deterioration (eg, lethargy, seizures) and aspirate The use of type IA and IC antidysrhythmics or other sodium channel blockade agents may exacerbate toxic effects of CAs on the myocardium The use

2014 eMedicine Emergency Medicine

29. Toxicity, Cocaine (Treatment)

been ingested (not as part of body packing or body stuffing), the patient without altered mental status may be treated by administration of activated aqueous charcoal. Gastric lavage and induction of vomiting via ipecac syrup are not recommended because of the risk of seizure, with the potential for airway compromise and aspiration of vomitus. Previous Next: Body Packing and Body Stuffing In body packers, although a risk for toxicity exists, the drugs are often carefully packaged to prevent rupture

2014 eMedicine Emergency Medicine

30. Toxicity, Beta-blocker (Treatment)

are essential. Prehospital administration of charcoal is indicated when there are no contraindications and the patient is alert and cooperative. If there is any alteration of mental status or concern that the patient may have a precipitous change in status, it is advisable to withhold charcoal. [ ] Ipecac syrup is contraindicated. Previous Next: Emergency Department Care If the patient is hypotensive, administer 20 mL/kg of isotonic intravenous fluids and place the patient in the Trendelenburg position

2014 eMedicine Emergency Medicine

31. Toxicity, Barbiturate (Treatment)

of a few specific antidotes has decreased the mortality rate in unselected overdose patients to less than 1% if the patient arrives at the hospital in time for the clinician to intervene. [ ] Although multiple doses of activated charcoal (MDAC) have been shown to enhance elimination of phenobarbital and to reduce the serum half-life, a definite improvement in clinical outcome has not been shown in any studies using MDAC. Induction of emesis with ipecac syrup is contraindicated in these patients because

2014 eMedicine Emergency Medicine

32. Toxicity, Neuroleptic Agents (Treatment)

charcoal and should be administered in standard doses as soon as possible postingestion. Multiple-dose activated charcoal is of limited benefit and cannot be used if an ileus is present. Ipecac syrup is never recommended. Hemoperfusion, hemodialysis, and forced diuresis are not effective. Seizures are treated in a stepwise fashion, beginning with benzodiazepines (eg, lorazepam, midazolam) and followed by barbiturates (eg, phenobarbital, pentobarbital). The combination of peripheral alpha-blockade

2014 eMedicine Emergency Medicine

33. Toxicity, Nonsteroidal Anti-inflammatory Agents (Treatment)

, breathing, and circulation (ABCs). For gastrointestinal (GI) decontamination, syrup of ipecac is no longer recommended and should not be administered for NSAID overdose in any circumstances. If the patient has no clinical evidence of a perforated viscous, decontaminate with activated charcoal (AC). The patient should be able to protect airway (eg, normal mental status, preserved gag reflex, absence of vomiting) in order to prevent aspiration of charcoal. Activated charcoal may not be warranted

2014 eMedicine Emergency Medicine

34. Toxicity, Mushroom (Treatment)

medications. If patients are severely agitated, anxiolytics (eg, benzodiazepines) may be needed. For seizures lasting longer than 5 minutes, various anticonvulsants have been used. It should be kept in mind that respiratory depression has been reported when these agents are administered IV. Preparations must therefore be made to support the airway if necessary. [ ] Ipecac syrup should generally be avoided. Central nervous system (CNS) symptoms develop relatively rapidly after ingestion of ibotenic acid (...) −containing mushrooms, and evidence for the effectiveness of ipecac in this setting is lacking. With A muscaria poisoning, despite the implications of the species name, few muscarinic effects are observed; consequently, anticholinergic drugs such as atropine are rarely, if ever, needed. Fever in this setting should not be treated with antipyretics; it is probably the result of agitation and increased motor activity. Previous Next: Prevention Cautious mushroom hunters eat only 1 type of mushroom and save

2014 eMedicine Emergency Medicine

35. Toxicity, Mushrooms (Treatment)

medications. If patients exhibit excessive bronchial secretions or other symptoms of cholinergic excess (bradycardia) that are of significant concern, atropine may decrease these symptoms. If the patient presents within 1 hour of ingestion, oral administration of activated charcoal may be considered, [ ] but adsorption to activated charcoal has not been demonstrated for these constituents. [ ] No evidence suggests that routine administration of multiple doses of activated charcoal is useful. Ipecac syrup

2014 eMedicine Emergency Medicine

36. Toxicity, Antihistamine (Treatment)

them down the toilet. Medication should be considered "medicine," not a toy or candy. Medicine should never be referred to as candy and, if possible, not administered in front of other children. Parents, relatives, and friends also should childproof their homes. Although ipecac syrup has fallen into disfavor in some medical circles, it is still recommended that parents have it readily available in the home for use with medical direction from a physician or poison control center. In instances

2014 eMedicine Emergency Medicine

37. Toxicity, Anticholinergic (Treatment)

. Obtain intravenous access and frequently monitor vital signs. Administer naloxone if respiratory depression due to opioid intoxication is suspected. Assess for hypoglycemia in patients with altered mental status. Manage seizures with benzodiazepines. Physostigmine is not recommended in the prehospital setting. Avoid ipecac syrup. Next: Emergency Department Care Initial assessment and stabilization are required in the emergency department (ED). Upon arrival, ensure that the airway is adequate

2014 eMedicine Emergency Medicine

38. Toxicity, Thyroid Hormone (Treatment) Full Text available with Trip Pro

correction of dehydration and control of hyperthermia. Important treatment points: Ipecac syrup is no longer recommended for home or hospital treatment. Asymptomatic patients should not be treated empirically with beta-blockers. Chronic overdose—withdraw drug. Use acetaminophen for fever control; aspirin is contraindicated because it displaces T4 from thyroid-binding globulin (TBG), increasing free T4. Because of the delayed conversion to T3 and distribution to tissues, patients must be observed

2014 eMedicine Emergency Medicine

39. Toxicity, Sedative-Hypnotics (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvODE4NDMwLXRyZWF0bWVudA== processing > Sedative-Hypnotic Toxicity Treatment & Management Updated: Dec 29, 2015 Author: Jeffrey S Cooper, MD, FAAEM, FACEP; Chief Editor: Asim Tarabar, MD Share Email Print Feedback Close Sections Sections Sedative-Hypnotic Toxicity Treatment Prehospital Care See the list below: Establish ABCs, obtain IV access, provide oxygen, and perform aggressive supportive care with airway protection as necessary. Ipecac syrup is not recommended for home use because of the fear of emesis after

2014 eMedicine Emergency Medicine

40. Digitalis Toxicity (Follow-up)

in patients with renal insufficiency. Other points to consider include the following: Induced emesis with ipecac syrup is not recommended, because of the increased vagal effect Whole-bowel irrigation may be useful, but clinical data are lacking Forced diuresis is not recommended, because it has not been shown to increase renal excretion and can worsen electrolyte abnormalities Dialysis has been shown to produce only small additional clearance Gastric lavage increases vagal tone and may precipitate

2014 eMedicine.com

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