Efficacy of ipecac and activated charcoal/cathartic. Prevention of salicylate absorption in a simulated overdose

Abstract

Adult volunteers (12) were given twenty-four 81-mg aspirin tablets and were randomly assigned into the following treatment groups: control aspirin, 30 ml of ipecac repeated if vomiting not induced, 60 g of activated charcoal per 15 g MgSO4 and ipecac repeated if needed, followed by activated charcoal/MgSO4 given 1.5 h after the last vomiting episode. All treatment began 60 min following aspirin ingestion. Urine was collected for 48 h for percent total salicylate excretion. Mean recovery of salicylate from urine was as follows: aspirin, 96.3 .+-. 7.5%; ipecac 70.3 .+-. 11.8%; activated charcoal/MgSO4, 56.4 .+-. 12%; and ipecac and activated charcoal/MgSO4, 72.4 .+-. 14.1%. Ten subjects completed the study. In group 4, 8 of 10 subjects vomited the activated charcoal/MgSO4 immediately, making statistical analysis impossible. Analysis revealed that activated charcoal/MGSO4 significantly lowered the absorption of aspirin compared with the control and ipecac-treated groups. Ipecac significantly lowered aspirin absorption compared with the control group. Evidently, activated charcoal/MgSO4 used alone is superior to the other treatment modalities at inhibiting the absorption of multiple aspirin tablets.