Ipecac toxicity: Difference between revisions
m (Mholtz moved page Ipecac to Ipecac toxicity) |
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*Occasionally seen used in Munchausen by proxy | *Occasionally seen used in Munchausen by proxy | ||
==Mechanism of Action== | ===Mechanism of Action=== | ||
*[[Vomiting]] | *[[Vomiting]] | ||
**Immediate: direct irritation of gastric mucosa | **Immediate: direct irritation of gastric mucosa | ||
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*Inhibition of protein synthesis in skeletal muscle | *Inhibition of protein synthesis in skeletal muscle | ||
==Toxic Dose== | ===Toxic Dose=== | ||
*Acute | *Acute | ||
**As little as 10 mL of the potent fluid extract can cause death | **As little as 10 mL of the potent fluid extract can cause death | ||
| Line 22: | Line 22: | ||
===Acute=== | ===Acute=== | ||
*[[Nausea/vomiting]] | *[[Nausea/vomiting]] | ||
*Gastritis | |||
===Chronic=== | ===Chronic=== | ||
*[[Dehydration]] | *[[Dehydration]] | ||
| Line 31: | Line 29: | ||
*[[Cardiomyopathy]] | *[[Cardiomyopathy]] | ||
*Myopathy ([[weakness]], hyporeflexia) | *Myopathy ([[weakness]], hyporeflexia) | ||
==Differential Diagnosis== | |||
==Evaluation== | ==Evaluation== | ||
*Emetine can be detected in urine for several weeks | *Emetine can be detected in urine for several weeks | ||
*Electrolytes | *Electrolytes, CPK, LDH | ||
*[[ECG]] | *[[ECG]] | ||
==Management== | ==Management== | ||
* | *No specific antidote exists | ||
*IV fluids | *Supportive care is mainstay of treatment | ||
* | **IV fluids | ||
**Electrolyte repletion | |||
==Disposition== | |||
==See Also== | |||
==External Links== | |||
==References== | ==References== | ||
<references/> | |||
[[Category:Toxicology]] [[Category:GI]] | [[Category:Toxicology]] | ||
[[Category:GI]] | |||
Revision as of 16:07, 17 November 2017
Background
- Rapidly acting emetic agent
- Derived from the ipecacuanha plant
- Often abused by adults with eating disorders
- Occasionally seen used in Munchausen by proxy
Mechanism of Action
- Vomiting
- Immediate: direct irritation of gastric mucosa
- Delayed: absorption, stimulation of chemoreceptor trigger zone
- Inhibition of protein synthesis in skeletal muscle
Toxic Dose
- Acute
- As little as 10 mL of the potent fluid extract can cause death
- 120 mL of syrup of ipecac unlikely to cause severe toxicity
- Chronic
- Slow elimination of emetine causes cumulative toxicity
- Daily ingestion of 90-120 mL of syrup for several months can cause cardiomyopathy and death
Clinical Features
Acute
- Nausea/vomiting
- Gastritis
Chronic
- Dehydration
- Diarrhea
- Hypokalemia
- Cardiomyopathy
- Myopathy (weakness, hyporeflexia)
Differential Diagnosis
Evaluation
- Emetine can be detected in urine for several weeks
- Electrolytes, CPK, LDH
- ECG
Management
- No specific antidote exists
- Supportive care is mainstay of treatment
- IV fluids
- Electrolyte repletion