Effectiveness of 15-mL versus 30-mL doses of syrup of ipecac in children
Krenzelok, E.P.; Dean, B.S.
Clinical Pharmacy 6(9): 715-717
1987
ISSN/ISBN: 0278-2677 PMID: 2890461 Document Number: 303495
The rates at which 15- and 30-mL doses of syrup of ipecac induced emesis within 30 minutes were evaluated in pediatric patients treated for accidental poisoning. A two-year prospective study was conducted to collect data on 4306 pediatric patients (aged one to six years) who received syrup of ipecac to treat accidental poisoning. Patients received either 15-mL (during 1983) or 30-mL (during 1984) doses of syrup of ipecac and 120-240 mL of water or clear liquid. Time of administration and time of the first episode of emesis were reported by the person administering the syrup of ipecac; the difference between these times was recorded as the time to emesis. Successful emesis was defined as emesis within 30 minutes after ipecac administration, while failure was defined as emesis occurring more than 30 minutes after administration. Success and failure rates were compared using chi-square analysis. Syrup of ipecac 15 mL was administered to 1905 patients, resulting in a failure-to-produce-emesis rate of 8.82% (168 patients). Syrup of ipecac 30 mL was administered to 2401 patients, resulting in a 0.08% failure rate (two patients). A repeat dose of ipecac syrup in the 15-mL group yielded a 99.74% success rate, which was not significantly different from the 99.96% success rate after a single dose of 30 mL. Although syrup of ipecac dosing in pediatric patients is controversial, our data suggest that increasing the standard pediatric dose from 15 to 30 mL significantly reduces the emesis failure rate.