Hydrogen Peroxide 3%
Hydrogen peroxide 3% is a widely available topical antiseptic that is frequently utilized in veterinary medicine as an **emergency oral emetic**, primarily in dogs. * **Clinical Pearl:** While it is a household staple, its use as an emetic is generally reserved for situations where immediate veterinary care is inaccessible and rapid decontamination is required. In a clinical setting, centrally acting emetics like **apomorphine** (for dogs) or **xylazine/dexmedetomidine** (for cats) are preferred due to higher efficacy and a lower risk of severe mucosal irritation. * **Feline Caution:** Its use in cats is increasingly discouraged by toxicologists due to a high risk of severe necrotizing hemorrhagic gastritis. * **Efficacy:** Successful induction of emesis does not ensure that stomach contents have been completely emptied; significant quantities of the ingested drug/toxin may remain or may have already been absorbed.
Mecanismo: Orally administered hydrogen peroxide (3%) induces a vomiting reflex via direct irritant effects on the oropharynx and gastric lining. * **Mechanism:** H₂O₂ interacts with the enzyme **catalase** present in tissue and blood → rapid release of water (H₂O) and oxygen gas (O₂) → massive bubbling and gastric distension. * The combination of direct mucosal irritation and sudden gastric distension stimulates visceral afferent vagal and sympathetic nerves → signals the **emetic center** in the medulla oblongata → triggers the vomiting reflex. * Emesis typically ensues within 10 minutes of administration.
Dosificación por especie
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes. Note: Use in cats is generally discouraged due to risk of severe gastric ulceration.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; generally not to exceed 50 mL for dogs and 10 mL for cats; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
- As an emetic · 1-2 mL/kg PO up to 2-3 times · PO · up to 2-3 times
- As an emetic · 1-5 mL/kg PO; may repeat one time if after 10 minutes emesis does not occur. · PO · may repeat one time if after 10 minutes emesis does not occur · Inducing emesis is most effective if administered after a small meal.
- As an emetic (pot-bellied pigs) · 1 teaspoon (5 mL) per 5 lbs. (2.3 kg) of body weight (approximately 2 mL/kg) not to exceed 3 tablespoons (45 mL). · PO · can be repeated once if not initially successful · Vomiting usually occurs within minutes.
Vías de administración
Contraindicaciones
- Animals already vomiting
- Severely lethargic, comatose, or debilitated animals (e.g., respiratory distress, decreased swallowing reflex, bradycardia)
- Seizuring or hyperactive animals
- Recent abdominal surgery
- Megaesophagus
- Ingestion of corrosives/caustics (e.g., acids, alkalis)
- Ingestion of sharp objects
- Ingestion of bagged illicit drugs
- Ingestion of hydrocarbons or petroleum distillates
- Rodents or rabbits (incapable of vomiting)
Efectos adversos
- Aspiration of hydrogen peroxide solution or stomach contents
- Vasovagal (bradycardic) response in animals with cardiovascular compromise
- Gastric ulceration (particularly in cats)
- Gastric-dilatation-volvulus (GDV) in dogs
Interacciones farmacológicas
- ACETYLCYSTEINE (oral) · Hydrogen peroxide can oxidize acetylcysteine in the gut; alternative emetics are preferred for acetaminophen overdoses.
- ANTIEMETICS (e.g., ondansetron, maropitant) · Preadministration or ingestion of these products may negate the emetic effects of hydrogen peroxide.
Monitoreo
- Efficacy (emesis, signs associated with toxicity of the substance ingested, blood levels of toxicants if applicable)
- Heart rate and respiration rate
- Thoracic auscultation after emesis (to monitor for aspiration pneumonia)
Sobredosis
Hydrogen peroxide 3% solution is relatively non-toxic after oral ingestion, though it can cause gastric irritation, vomiting, and rarely gastric ulceration or GDV. > **DANGER:** Hydrogen peroxide in concentrations of **10% or greater** (such as hair bleach or industrial peroxide) can be very corrosive, causing severe burns to the oral and gastric mucosa, and can induce fatal oxygen emboli after oral ingestion.
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