A clinical trial using syrup of ipecac and activated charcoal concurrently.

A prospective study was conducted to determine if the emetic effects of syrup of ipecac are preserved when activated charcoal is administered prior to emesis. Ten overdose patients who fulfilled the entrance criteria for the study were administered 60 mL syrup of ipecac by a nasogastric tube followed immediately by 500 mL of tap water. Ten minutes after the ipecac was administered, an aqueous slurry of 50 g activated charcoal diluted to 500 mL was instilled down the nasogastric tube and the tube was removed. Emetic response and time to emesis were recorded. Thirty minutes after emesis subsided, a second dose of 50 g activated charcoal (with sorbitol) was administered orally. Emetic responses were noted in all ten patients. The patients averaged 3.7 emetic episodes. Emesis commenced in an average of 13.8 minutes from the start of ipecac administration and concluded in an average of 45.9 minutes. These results in patients are similar to those observed in a previously reported volunteer group similarly treated. This protocol allows early administration of activated charcoal while preserving the emetic properties of syrup of ipecac in the patients treated.

Preserving the emetic effect of syrup of ipecac with concurrent activated charcoal administration: a preliminary study.

Activated charcoal is reported to block the emetic effect of syrup of ipecac. Therefore, activated charcoal administration is commonly delayed until syrup of ipecac induced emesis is complete. The advantages of early administration of activated charcoal have been well documented. Preservation of the emetic effect of syrup of ipecac in the presence of activated charcoal may produce a synergistic effect by enhancing toxin elimination. A study was conducted in ten human volunteers to determine if activated charcoal prevents the emetic effect of syrup of ipecac when a temporal separation exists between administration of the two substances. Syrup of ipecac 60 ml plus water 480 ml was administered via an 18 French nasogastric tube followed by an aqueous slurry of activated charcoal 50 g five minutes later. Eight (80%) of the subjects had emesis in a mean time of 20.25 minutes (range 16-26 min). The total dose of activated charcoal was retained for a mean time of 6.75 minutes (range 0-17 min). Two subjects (20%) failed to have emesis. This study illustrates that activated charcoal may not completely block the emetic effect of syrup of ipecac.