The Experts below are selected from a list of 147 Experts worldwide ranked by ideXlab platform
Michael Shannon - One of the best experts on this subject based on the ideXlab platform.
-
the demise of Ipecac
Pediatrics, 2003Co-Authors: Michael ShannonAbstract:In 1965, at the urging of 4 organizations (the American Academy of Pediatrics, the American Medical Association, the American Association of Poison Control Centers, and the Food and Drug Administration’s [FDA’s] Medical Advisory Board), the FDA agreed to grant syrup of Ipecac over-the-counter status.1,2 Over the previous 12 years, pediatricians and toxicologists were persuaded that the drug was both safe and effective for treatment of childhood poisonings, justifying its unrestricted availability. In 1985, the Academy recommended that Ipecac be discussed with and given to parents at the 6-month (infant) visit.3,4 Although the efficacy of Ipecac at improving outcome after childhood poisoning had not been rigorously proven and despite reports of failures,5 adverse outcomes,6,7 and even malicious use, the medication became an integral part of pediatric anticipatory guidance. Widespread use of Ipecac in poisoned children was strongly advocated both because of its apparent ability to reduce morbidity and because it significantly reduced the need for emergency department referral.8 …
Benito J. Cerimele - One of the best experts on this subject based on the ideXlab platform.
-
Effect of Zatosetron on Ipecac‐Induced Emesis in Dogs and Healthy Men
The Journal of Clinical Pharmacology, 1994Co-Authors: Steven M. Schwartz, Mark J. Goldberg, Jaswant Singh Gidda, Benito J. CerimeleAbstract: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 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 emesis in both groups. In dogs, zatosetron inhibited Ipecac-induced emesis in a dose-dependent manner with a 100-μg/kg dose producing complete inhibition. In men, zatosetron administration resulted in fewer emetic episodes after Ipecac than had occurred with placebo administration (P = .03); vomiting was completely inhibited by zatosetron. In men, Ipecac administration did not affect the urinary 5-HIAA/creatinine ratio (mg/g) or 5-HIAA excretion rate (μg/hour). Our study demonstrates that zatosetron has similar efficacy on Ipecac-induced emesis in healthy men, as has been shown previously with other 5-HT3 receptor antagonists in chemotherapy-induced emesis in cancer patients. We did not observe the increase of urinary 5-HIAA in our study with Ipecac-induced emesis, however, as has been described previously in cisplatin-induced emesis. Our study indicates that Ipecac-induced emesis may be a useful model for testing 5-HT3 receptor antagonists for antiemetic activity in dogs and healthy men.
-
effect of zatosetron on Ipecac induced emesis in dogs and healthy men
The Journal of Clinical Pharmacology, 1994Co-Authors: Steven M. Schwartz, Mark J. Goldberg, Jaswant Singh Gidda, Benito J. CerimeleAbstract: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 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 emesis in both groups. In dogs, zatosetron inhibited Ipecac-induced emesis in a dose-dependent manner with a 100-μg/kg dose producing complete inhibition. In men, zatosetron administration resulted in fewer emetic episodes after Ipecac than had occurred with placebo administration (P = .03); vomiting was completely inhibited by zatosetron. In men, Ipecac administration did not affect the urinary 5-HIAA/creatinine ratio (mg/g) or 5-HIAA excretion rate (μg/hour). Our study demonstrates that zatosetron has similar efficacy on Ipecac-induced emesis in healthy men, as has been shown previously with other 5-HT3 receptor antagonists in chemotherapy-induced emesis in cancer patients. We did not observe the increase of urinary 5-HIAA in our study with Ipecac-induced emesis, however, as has been described previously in cisplatin-induced emesis. Our study indicates that Ipecac-induced emesis may be a useful model for testing 5-HT3 receptor antagonists for antiemetic activity in dogs and healthy men.
William D King - One of the best experts on this subject based on the ideXlab platform.
-
effects on a poison center s pc triage and follow up after implementing the no Ipecac use policy
Journal of Medical Toxicology, 2010Co-Authors: Robert M Lapus, Ann P Slattery, William D KingAbstract:For years, The American Academy of Pediatrics (AAP) had supported home use of syrup of Ipecac. However, due to mounting evidence that Ipecac use did not improve outcome nor reduce Emergency Department (ED) referrals, the AAP in November of 2003 issued a statement that Ipecac not be used for the home management of poison ingestion. To determine if the cessation of the use of Ipecac for home ingestions is associated with an increased number of follow-up calls, an increased time of observation at home and an increase in the number of ED referrals for care by poison center staff were administered. Fifty randomly selected pediatric (<6 years) cases that received Ipecac (“Ipecac” group) from January 1, 2003 to October 31, 2003 were selected for study. Up to two controls (“no Ipecac” group) were matched by age, amount ingested, and by toxin. Controls were selected from the 2004–2006 time period (Ipecac no longer in use). Fifty “Ipecac” cases and 84 “no Ipecac” controls were analyzed. The groups had no significant differences with respect to percent symptomatic, median time post-ingestion, mean age, and distribution of toxin categories (e.g., antidepressants, beta blockers, etc.). The “no Ipecac” group had nearly ten times the odds of ED referral compared to the “Ipecac” group, (OR = 9.9, 95%CI 3.3–32.2). The mean total hours of follow-up was not significantly different between the groups (diff = −1.1, t = −1.8, p = 0.07). The mean number of follow-up calls was significantly less in the “no Ipecac” group (diff = −1.4 calls, t = −6.8, p < 0.001). Toxicology consults were greater in the “no Ipecac” group (χ2 = 4.05, p = 0.04); however, consults were not associated with ED referral. For the time period from 2004 to 2006, the “no Ipecac” policy resulted in an increase in ED referrals at our center. While prior studies have shown that not using Ipecac did not affect clinical outcome, our research suggested that it may have initially influenced triaging outcome. Since the use of Ipecac by centers was once a commonly used home remedy for some ingestions (albeit without rigorously established efficacy), poison center personnel had to transition to the “no Ipecac” policy. Although our referrals increased during a transitional period of time, referral rates have since stabilized and returned to baseline.
-
Effects on a Poison Center’s (PC) Triage and Follow-up After Implementing the No Ipecac Use Policy
Journal of Medical Toxicology, 2010Co-Authors: Robert M Lapus, Ann P Slattery, William D KingAbstract:For years, The American Academy of Pediatrics (AAP) had supported home use of syrup of Ipecac. However, due to mounting evidence that Ipecac use did not improve outcome nor reduce Emergency Department (ED) referrals, the AAP in November of 2003 issued a statement that Ipecac not be used for the home management of poison ingestion. To determine if the cessation of the use of Ipecac for home ingestions is associated with an increased number of follow-up calls, an increased time of observation at home and an increase in the number of ED referrals for care by poison center staff were administered. Fifty randomly selected pediatric (
Sarai H Sanchez - One of the best experts on this subject based on the ideXlab platform.
-
Is Syrup of Ipecac Still for Sale? Comparison of Pharmacies in a Large Urban Area—2003 Versus 2005
Clinical Pediatrics, 2020Co-Authors: Nancy R Kelly, Sarai H SanchezAbstract:There has been considerable publicity about the lack of benefit and potential dangers of syrup of Ipecac. In November 2003, the American Academy of Pediatrics recommended against its use. Pharmacies in Houston, Texas were surveyed by telephone before (survey 1) and after (survey 2) the American Academy of Pediatrics' recommendation to determine whether Ipecac availability changed. There were 126 pharmacies interviewed at survey 1, and 128 interviewed at survey 2. Pharmacies in survey 1 were more likely than those in survey 2 to sell Ipecac (79% versus 64%, P < .01) and to have it in stock (75% versus 48%, P < .001). Pharmacies mostly stored Ipecac on the shelves (67%, survey 1; 59%, survey 2, P = .27). Although syrup of Ipecac availability has declined significantly, it is still available in more than 50% of pharmacies. Health care providers should advise against its use and advocate that pharmacies remove it.
-
is syrup of Ipecac still for sale comparison of pharmacies in a large urban area 2003 versus 2005
Clinical Pediatrics, 2007Co-Authors: Nancy R Kelly, Sarai H SanchezAbstract:There has been considerable publicity about the lack of benefit and potential dangers of syrup of Ipecac. In November 2003, the American Academy of Pediatrics recommended against its use. Pharmacies in Houston, Texas were surveyed by telephone before (survey 1) and after (survey 2) the American Academy of Pediatrics' recommendation to determine whether Ipecac availability changed. There were 126 pharmacies interviewed at survey 1, and 128 interviewed at survey 2. Pharmacies in survey 1 were more likely than those in survey 2 to sell Ipecac (79% versus 64%, P < .01) and to have it in stock (75% versus 48%, P < .001). Pharmacies mostly stored Ipecac on the shelves (67%, survey 1; 59%, survey 2, P = .27). Although syrup of Ipecac availability has declined significantly, it is still available in more than 50% of pharmacies. Health care providers should advise against its use and advocate that pharmacies remove it.
Herbert G Bivins - One of the best experts on this subject based on the ideXlab platform.
-
evaluation of gastric emptying using radionuclides gastric lavage versus Ipecac induced emesis
Annals of Emergency Medicine, 1993Co-Authors: William F Young, Herbert G BivinsAbstract:STUDY OBJECTIVES: To compare the efficacy of gastric lavage and Ipecac-induced emesis by using a radionuclide marker in a simulated overdose and to determine the amount of material recoverable after lavage fluid appears clear. DESIGN: Case-control, prospective cross-over study. SETTING: Nuclear medicine department of Valley Medical Center, Fresno, California. TYPE OF PARTICIPANTS: Fourteen male and five nonpregnant female adult volunteers with no pre-existing gastrointestinal disease and no medication use. INTERVENTIONS AND MEASUREMENTS: In phase 1, each volunteer ingested 30 capsules labeled with a measured amount of Tc99m with 75 mL H2O followed in five minutes by Ipecac-induced emesis. In phase 2, two to four weeks later, each subject was lavaged after ingesting 30 labeled capsules. After lavage appeared clear, a 1,000-mL supplemental lavage was done and analyzed separately. All emesis or gastric lavage fluid was collected and measured for tracer activity. RESULTS: All subjects in the Ipecac group vomited with an average time from Ipecac to emesis of 19 minutes. Two subjects withdrew from the study, refusing to complete lavage due to discomfort. Based on retrieved material, Ipecac-induced emesis returned significantly more tracer (mean +/- SD, 54.1 +/- 21.3%) than lavage until clear (mean +/- SD, 30.3 +/- 17.4%) (P = .0021). Supplemental lavage returned 12.9% of the total recovered marker (SD, 11.6%). The total of initial and supplemental returns from lavage was 35.5% (SD, 21.0%). This return was significantly less than that returned by Ipecac-induced emesis (P = .016). CONCLUSION: In this study, Ipecac-induced emesis was significantly more effective than gastric lavage in emptying the stomach after simulated overdose. Significant amounts of ingested material are recoverable in gastric lavage return after it appears clear.