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Syrup of Ipecac

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101. Validity of self reported home safety practices (PubMed)

' home safety practices of using smoke alarms and stair gates, and having syrup of ipecac. SETTING: Families from a pediatric continuity clinic in a large, urban teaching hospital with infants from birth to 6 months were enrolled in the study. METHODS: As part of a randomized controlled trial to promote home safety, parents' responses to personal interviews were compared to observations made in the respondents' homes two to four weeks after the interview. Positive and negative predictive values

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2003 Injury prevention journal of the International Society for Child and Adolescent Injury Prevention

102. Evaluation of kiosk-based tailoring to promote household safety behaviors in an urban pediatric primary care practice. (PubMed)

control (n = 74) and intervention parents completed a telephone interview. Safety knowledge, beliefs, and practices were compared at follow-up. Compared to control group parents, intervention group parents were more knowledgeable about the inappropriateness of young children riding in the front seat of a car (16% versus 5%, p < 0.05), less likely to believe that teaching a child to mind you is the best way to prevent injuries (64% versus 86%, p < 0.05), and more likely to report that they "have syrup (...) of ipecac" (34% versus 9%, p < 0.001) and "know how to use" it (24% versus 4%, p < 0.002). This study provides further support for the use of tailored communication to address the prevention of injuries to young children but calls for continued investigation in the area.

2005 Patient education and counseling

103. Plasma salicylate from methyl salicylate cream compared to oil of wintergreen. (PubMed)

Plasma salicylate from methyl salicylate cream compared to oil of wintergreen. Poison Control Centers follow the acetylsalicylic acid (ASA) treatment guideline to manage unintentional ingestions of topical methyl salicylate liniments. For example, one teaspoon of 30% methyl salicylate cream such as Ben Gay provides an "ASA equivalent dose" of 180 mg/kg for a 10 kg child. The ASA treatment guideline advises emesis with syrup of Ipecac and 24 h home followup for this dose. Both the ASA conversion

2003 Journal of toxicology. Clinical toxicology

104. Poison treatment in the home. American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. (PubMed)

initiatives. A key AAP recommendation has been to keep a 1-oz bottle of syrup of ipecac in the home to be used only on the advice of a physician or poison control center. Recently, there has been interest regarding activated charcoal in the home as a poison treatment strategy. After reviewing the evidence, the AAP believes that ipecac should no longer be used routinely as a home treatment strategy, that existing ipecac in the home should be disposed of safely, and that it is premature to recommend

2003 Pediatrics

105. Sildenafil citrate ingestion in a pediatric patient. (PubMed)

(Viagra) 2 hours prior to arrival at an emergency room. Ipecac syrup had been given at home with one episode of vomiting. Activated charcoal was considered but withheld due to the delayed presentation to the hospital. The patient was observed in the hospital for 17.5 hours. Observed clinical effects included facial flushing, transient penile engorgement, bilateral rhonchi, and diarrhea. No significant cardiovascular effects were seen. A bronchodilator was given with resolution of rhonchi. No other (...) and diarrhea were related since neither has been described following sildenafil exposure. Significant cardiovascular symptoms were not seen. Early administration of ipecac syrup did not prevent symptoms from developing.

2004 Pediatric Emergency Care

106. Poisoning prevention knowledge and practices of parents after a childhood poisoning incident. (PubMed)

Poisoning prevention knowledge and practices of parents after a childhood poisoning incident. This study investigated the effectiveness of a poison center-initiated mailed intervention on improving the preventive practices of families whose preschool child had recently experienced a poisoning incident. A low-cost, mailed poisoning prevention packet consisting of telephone stickers, a +f41 coupon for syrup of ipecac, one slide-style cabinet lock, a nine-step checklist for "poison-proofing (...) " the home, pamphlets, and a cover letter was tested prospectively on a population of parents calling a poison center for advice about possible poisoning exposures involving their preschool children. Parents without ipecac 1 week after the incident were randomized so that half received the mailed intervention. A "blind" follow-up telephone interview was conducted 3 months later. Of the 336 original families enrolled in the study, 301 (90% retention) completed the follow-up interview. Those who had

1992 Pediatrics

107. Management of acutely poisoned patients without gastric emptying. (PubMed)

Management of acutely poisoned patients without gastric emptying. During an 18-month period, 592 acute oral drug overdose patients were studied prospectively in a controlled, randomized fashion to determine the efficacy of gastric emptying procedures in altering clinical outcome. Patients presenting on even-numbered days had no gastric emptying procedures performed, and they were compared to patients presenting on odd-numbered days who received either syrup of ipecac or gastric lavage. Patients (...) were carefully followed for evidence of subsequent clinical improvement or deterioration after initial management. Syrup of ipecac did not significantly alter the clinical outcome of patients who were awake and alert on presentation to the emergency department (ED). Gastric lavage in obtunded patients led to a more satisfactory clinical outcome (P less than .05) only if performed within one hour of ingestion. Gastric emptying procedures in the ED for initial treatment of drug overdose are generally

1985 Annals of Emergency Medicine

108. Prevention of childhood poisoning: efficacy of an educational program carried out in an emergency clinic. (PubMed)

clinic, can introduce the topic of poisoning prevention to families and can encourage the storage of syrup of ipecac in the home. (...) of the Massachusetts Poison Center, (2) to ensure that parents have ipecac for use in an emergency, and (3) to counsel parents on how to use ipecac. Of 403 families recruited from the emergency clinic and divided randomly into intervention and nonintervention groups, 262 families completed the follow-up interview 6 months later (65%). Results showed that 68% of intervention families compared with 42% of control families reported ipecac storage at follow-up (chi 2 = 7.65, P = .005) and that 40% of intervention

1987 Pediatrics

109. Evaluation of a community based childhood injury prevention program. (PubMed)

and drawers, and syrup of ipecac in the home.A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety.

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1997 Injury Prevention

110. Evaluation of a poison prevention lesson for kindergarten and third grade students (PubMed)

poisons, although fewer than 50% said they had syrup of ipecac in their homes.These results show that key concepts related to poison prevention can be communicated effectively to primary school students and parents report having homes safe from many poisons.

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1998 Injury Prevention

111. Availability of antidotes at acute care hospitals in Ontario (PubMed)

immune Fab antibody fragments, a life-saving antidote for patients with severe digoxin toxicity, whereas most of the hospitals stocked sufficient supplies of ipecac syrup (88%) and flumazenil (92%), arguably the least crucial antidotes in the survey. Only 1 hospital stocked adequate amounts of all 10 antidotes. Certain hospital characteristics were associated with adequate antidote stocking (increased annual emergency department volume, teaching hospital status and designation as a trauma centre

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2001 CMAJ: Canadian Medical Association Journal

112. A review of the management of oral drug overdose in the Accident and Emergency Department of the Royal Brisbane Hospital. (PubMed)

method of preventing further absorption of an ingested drug. The use of syrup of ipecac was not encouraged and orogastric lavage was used in only specific situations. The morbidity and mortality of these patients when compared with other studies, was not adversely affected by this protocol which dramatically reduced the indications for the use of orogastric lavage and syrup of ipecac.

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1991 Archives of Emergency Medicine

113. Efficacy of ipecac during the first hour after drug ingestion in human volunteers. (PubMed)

Efficacy of ipecac during the first hour after drug ingestion in human volunteers. To determine the decrease of drug absorption when syrup of ipecac is administered at various times within one hour of drug ingestion.Ten healthy human volunteers were recruited for a four-limbed randomized crossover study. The three experimental limbs consisted of administration of 30 mL syrup of ipecac, at 5, 30, or 60 minutes after ingestion of 3900 mg acetaminophen as 12 x 325 mg tablets with 250 mL room (...) . This corresponds to decreases in bioavailability of 67, 11, and 21%. Only the 5-minute group differed significantly from control (p < 0.05). Sedation was observed as a significant adverse effect of ipecac administration.Our data do not support benefit from ipecac administration at 30 minutes and beyond. Our data suggest that benefit is lost at some point between 5 and 30 minutes. The sedative effect of ipecac may confound the observation of patients who have ingested sedative hypnotic agents.

1997 Journal of toxicology. Clinical toxicology

114. Pediatric ingestions: charcoal alone versus ipecac and charcoal. (PubMed)

Pediatric ingestions: charcoal alone versus ipecac and charcoal. To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time.During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial.All patients were recruited and studied in a pediatric emergency department.Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral (...) less than .05).Ipecac delays the administration of AC, hinders its retention, and prolongs ED time in pediatric ingestion patients. These data support the recommendation that AC alone should be the gastrointestinal decontamination method of choice for the mild-to-moderate pediatric ingestion patient presenting to an ED.

1991 Annals of Emergency Medicine

115. Effect of zatosetron on ipecac-induced emesis in dogs and healthy men. (PubMed)

evaluated the effect of ipecac administration on serotonin release and metabolism by measuring urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion in healthy men. In separate randomized, placebo-controlled trials, 20 dogs received zatosetron intravenously and eight healthy men received zatosetron (50 mg) orally, followed by ipecac syrup. In both trials, emetic response to ipecac was recorded, including the number and time of vomits and retches. Zatosetron treatment inhibited and delayed ipecac-induced (...) Effect of zatosetron on ipecac-induced emesis in dogs and healthy men. Serotonin receptor (5-HT3) antagonists provide effective antiemetic therapy in cancer patients receiving emetogenic chemotherapy, such as cisplatin. Animal studies have shown that 5-HT3 receptor antagonists also have antiemetic activity in ipecac-induced emesis. The authors investigated the antiemetic activity of zatosetron maleate, a 5-HT3 receptor antagonist, on ipecac-induced emesis in dogs and healthy men. They also

1994 Journal of clinical pharmacology

116. Low-volume whole bowel irrigation and salicylate absorption: a comparison with ipecac-charcoal. (PubMed)

Low-volume whole bowel irrigation and salicylate absorption: a comparison with ipecac-charcoal. To evaluate two methods of gastrointestinal decontamination, low-volume whole bowel irrigation (WBI) and activated charcoal, for their ability to prevent absorption of salicylate.Randomized, two-phase crossover study.A clinical research unit in a university-based teaching hospital.Six healthy, volunteer men.Subjects were assigned to receive 3000 ml WBI or syrup of ipecac 30 ml followed by activated (...) charcoal 50 g in sorbitol, and were crossed over to the other treatment phase after 1 week. All treatments began 30 minutes after ingestion of 3.25 g aspirin. Urine was collected over 24 hours for analysis of total urinary excretion of salicylate. Serial blood samples were collected for salicylate determination and were subjected to pharmacokinetic analysis.Mean +/- SD recovery of salicylate were WBI 48.6 +/- 5.4% and ipecac-charcoal 37.0 +/- 2.6% from urine (p < 0.01).Ipecac-charcoal produced

1993 Pharmacotherapy

117. Should home ipecac-induced emesis be routinely recommended in the management of toxic berry ingestions? (PubMed)

Should home ipecac-induced emesis be routinely recommended in the management of toxic berry ingestions? Poison center (PC) management of toxic berry ingestions may include recommendations to administer syrup of ipecac (SI) regardless of the number of berries ingested. We investigated whether the routine use of SI in the home management of asymptomatic single or few (< 6) berry ingestions may be unnecessary. A prospective, randomized clinical trial compared SI + home observation (HO) to HO alone

1999 Veterinary and human toxicology

118. Efficacy of charcoal cathartic versus ipecac in reducing serum acetaminophen in a simulated overdose. (PubMed)

therapy with ipecac with therapy with activated charcoal-cathartic in a simulated acetaminophen overdosage. Ten healthy volunteers participated in a randomized, crossover trial. Subjects ingested 3.0 g acetaminophen, followed by either no intervention, 30 mL syrup of ipecac, or 50 g activated charcoal-sorbitol solution at one hour. Serial acetaminophen levels were determined at intervals over eight hours. Both interventions significantly reduced the area under the curve compared with control (P less (...) Efficacy of charcoal cathartic versus ipecac in reducing serum acetaminophen in a simulated overdose. The traditional role of gastric emptying as the initial step in the management of the poisoned patient has recently been questioned; immediate activated charcoal administration has been recommended by some. In the setting of acetaminophen overdose, ipecac-induced emesis may interfere with subsequent oral antidotal therapy. Therefore, we conducted a study to compare the efficacy of initial

1989 Annals of Emergency Medicine

119. The effect of carbonated beverages on ipecac-induced emesis. (PubMed)

The effect of carbonated beverages on ipecac-induced emesis. To determine the effect of carbonated beverages on syrup of ipecac, 24 pediatric patients were randomly administered six ounces of water or a carbonated beverage with syrup of ipecac. Changes in the abdominal girth, the volume of emesis, and time of emesis were monitored in all patients. In the carbonated beverage group a significant difference (P less than 0.05) was observed between the baseline and 10-min post-ipecac administration (...) abdominal girth measurements. The time of emesis and volume of emesis were not significantly different in the water or carbonated beverage groups. We conclude that carbonated beverage administration does not alter the effectiveness of syrup of ipecac.

1981 Annals of Emergency Medicine

120. Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. (PubMed)

Superiority of activated charcoal alone compared with ipecac and activated charcoal in the treatment of acute toxic ingestions. A prospective, randomized clinical trial compared the clinical effectiveness of syrup of ipecac and activated charcoal to that of activated charcoal alone in the treatment of acute toxic ingestions. Two hundred adult patients with mild to moderate oral overdoses were entered into the trial. Patients receiving only activated charcoal were discharged from the emergency (...) department in significantly (P less than or equal to .05) less time than those receiving both syrup of ipecac and activated charcoal (6.0 +/- 0.3 vs 6.8 +/- 0.2 hours, respectively). The percentage of patients requiring nonpsychiatric hospitalizations was not significantly different between the two groups (11.2% vs 14.0%, respectively). For the hospitalized patients, the length of time spent in the ICU and in the hospital was not statistically different between the two groups. A complication rate of 5.4

1989 Annals of Emergency Medicine

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