EMETICS — Complete Summary
Definition
Emetics are drugs that induce vomiting in animals capable of vomiting (mainly dogs and cats).
They help remove ingested poisons and stomach contents.
MECHANISM
Vomiting is coordinated by the Vomiting Centre (VC) in the medulla.
Input to Vomiting Centre
1. Chemoreceptor Trigger Zone (CTZ)
Detects blood-borne toxins
Neurotransmitters: D₂, 5-HT₃
2. Vestibular apparatus
Motion sickness
Neurotransmitters: Histamine (H₁), Muscarinic (M)
3. Vagal afferents (gut, heart, testes)
Neurotransmitter: 5-HT₃
4. Direct GIT irritation → reflex vomiting
CLASSIFICATION OF EMETICS
(Based on mechanism of action)
A. Centrally Acting Emetics
Act on the CTZ or Vomiting Centre.
1. Apomorphine
D₂ receptor agonist acting on CTZ
Highly effective in dogs
Contraindicated in cats → causes CNS excitement
Routes:
Oral: 3–5 mg/kg
IV: 0.02 mg/kg
SC: 0.25 mg/kg
Eye tablet (conjunctival sac) as lamella
⚠️ Repeated dosing ineffective → apomorphine depresses the emetic centre after first dose
2. Xylazine
α₂-adrenoceptor agonist
Very effective emetic in cats
Dose: 0.3–0.5 mg/kg IV or IM
Causes sedation & hypotension
3. Ipecac (Syrup of Ipecacuanha)
Mixed action:
Central action on CTZ
Peripheral irritation of gastric mucosa
Vomiting occurs within 15–30 min
Dog dose: 2.5–5 mL/kg orally
⚠️ High doses are cardiotoxic → arrhythmia, myocarditis
⚠️ If vomiting does not occur → perform gastric lavage
⚠️ Do NOT administer with activated charcoal (charcoal adsorbs ipecac → no emesis)
B. Reflex / Peripheral Acting Emetics
Act by irritating the pharynx or gastric mucosa → stimulate vagal afferents → VC.
Examples
Warm water
Warm saturated NaCl solution
Salt crystals placed on the back of the tongue
Sodium carbonate crystals
Copper sulphate
50 mL of 1% solution
Zinc sulphate
50 mL of 1% solution
Mustard paste
Hydrogen peroxide 3%
Dog dose: 5–10 mL orally
Inorganic salts (dogs)
Sodium chloride / sodium carbonate / copper sulphate
Dose: 5–10 g into pharynx
C. Mixed-Action Emetics
Act both centrally and peripherally.
Ipecac syrup (Emetine)
Already described above in central emetics
Central + local irritant action
Dog dose: 2.5–5 mL/kg orally
CLINICAL USES OF EMETICS
1. Removal of ingested poisons
(except corrosives & petroleum products)
2. Emptying stomach before emergency surgery
3. Expulsion of gastric material in certain clinical settings
CONTRAINDICATIONS (Don’t Use Emetics In):
❌ Unconscious animals
❌ Corrosive poison ingestion (acids/alkalis)
❌ Petroleum product ingestion
❌ Opium poisoning
❌ CNS stimulant toxicity
❌ Weak or debilitated animals
❌ Pregnancy
❌ Bowel obstruction / hernia
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