Brand Name
Ipecac Syrup
Class and Category
Chemical class: Cephaelis acuminata or Cephaelis
ipecacuanha derivative
Therapeutic class: Emetic
Pregnancy category: C
Indications and Dosages
To induce vomiting after drug overdose and certain types of
poisoning
SYRUP
Adults and children over age 12. 15 to 30
ml followed by 240 ml water. Dose repeated if vomiting doesn’t begin within 20
to 30 min.
Children ages 1 to 12. 15 ml preceded or followed by 120
to 240 ml water. Dose repeated if vomiting doesn’t begin within 20 to 30 min.
Infants ages 6 months to 1 year. 5 to 10 ml
preceded or followed by 120 to 240 ml water.
Route Onset
Peak Duration
P.O. 20–30
min Unknown 20–25 min
Mechanism of Action
Induces vomiting by irritating gastric mucosa and stimulating
medullary chemoreceptor trigger zone in CNS.
Contraindications
Loss of gag reflex, poisoning with strychnine or corrosives (such
as alkaloid substances, petroleum distillates, and strong acids), seizures,
semiconsciousness or unconsciousness, severe inebriation, shock
Interactions
DRUGS
activated charcoal: Lack of emetic effect
Adverse Reactions
CNS: Depression, drowsiness
EENT: Aspiration of vomitus, coughing
GI: Diarrhea,
indigestion
Nursing Considerations
• Give ipecac syrup only to conscious patients, and follow with
adequate water. Give young or frightened children water before or after ipecac.
• Expect vomiting to start in 20 to 30 minutes.
• If vomiting doesn’t start within 30 minutes of second dose,
prepare for gastric lavage.
• Don’t give ipecac after ingestion of petroleum distillates, such
as gasoline, or caustic substances, to avoid further injury to esophagus.
• If activated charcoal will be given, expect to do so after
patient vomits or 30 minutes after second ipecac dose because activated charcoal
adsorbs and inhibits ipecac.
• Arrhythmias, atrial fibrillation, bradycardia, fatal
myocarditis, hypotension, myalgia, or muscle stiffness or weakness may develop
if patient takes too much ipecac or doesn’t vomit.
PATIENT TEACHING
• Inform patient of ipecac’s effects.
• Tell adult patient to drink 8 oz (240 ml) of water after taking
drug and child to drink 4 to 8 oz (120 to 240 ml) before or after taking drug.
• Inform patient or parents of child that diarrhea may occur after
taking drug.
• Urge parents to keep ipecac syrup and phone number of a poison
control center.
WARNING Advise parents to replace their ipecac
extract or tincture with ipecac syrup. Explain that ipecac fluid extract is 14
times more concentrated than ipecac syrup and can cause serious, possibly toxic,
effects if given incorrectly.
