Summer 2004 Volume Seven Number Two  
   
Poison Pill Still?
 

Perusing the “Things That We Once Thought Were Good For Kids But Now Have Decided They Aren’t” shop provides for some interesting browsing.

There’s the “Babies Should Sleep On Their Stomachs” department (they shouldn’t). And there’s the “A Little Alcoholic Beverage Is Good for Breastfeeding” boutique (probably not a good idea).

Well, add syrup of ipecac to the aisle.

For years, doctors have recommended that parents keep a bottle of ipecac handy in case their children accidentally swallowed something poisonous. The ipecac would induce vomiting, clearing the stomach of the poison.

Recently, the American Academy of Pediatrics (AAP) has reversed this long-standing position, now recommending that instead of using syrup of ipecac, parents should first call their nearest poison control center.

The AAP felt the use of ipecac was based more on intuition that it should work, rather than it actually did work. It was thought if there was poison in a child’s stomach, the best thing to do was to get it out. And ipecac was shown to cause vomiting 85 to 100 percent of the time.

Over the years, evidence against ipecac seemed to mount:

• The list of medications where vomiting a poison would do more harm than good grew bigger and bigger. Some chemicals were found to damage the lining of the throat.

• People were abusing ipecac, using it to vomit and control their weight.

• Activated charcoal became the standard of treatment for poisonings. Poisons would cling to the charcoal and pass though the body without being absorbed. Ipecac could get in the way, at times, causing children to throw-up the charcoal.

• Ipecac itself is not without its own set of side effects. It can cause prolonged vomiting as well as sleepiness. This could complicate diagnosis and delay treatment.

Over the past 15 years, the use of ipecac as recommended by regional poison control centers has declined by 95 percent.

Today, the use of ipecac is being reviewed by the Food and Drug Administration and it may lose its over-the-counter status. If that’s the case, the day will have passed when bottles of ipecac sit in the cupboards of parents with young children.