Pulvis Ipecacuanhae et Opii (U. S. P.)—Powder of Ipecac and Opium.
SYNONYMS: Dover's powder, Compound powder of ipecacuanha, Pulvis ipecacuanhae compositus.
Preparation and History.—"Ipecac, in No. 60 powder, ten grammes (10 Gm.) [154 grs.]; powdered opium, ten grammes (10 Gm.) [154 grs.]; sugar of milk, in No. 30 powder, eighty grammes (80 Gm.) [2 ozs. av., 360 grs.]; to make one hundred grammes (100 Gm.) [3 ozs. av., 231 grs.]. Rub them together into a very fine powder"—(U. S. P.).
Each 10 grains of Dover's powder contain of opium and ipecacuanha, each, 1 grain, and sugar of milk, 8 grains. Formerly potassium sulphate was employed in the place of milk sugar. The potassium salt is still directed in the British Pharmacopoeia, giving to the preparation of the latter a somewhat saline taste. The sugar of milk in this preparation is employed simply as a diluent. By triturating it in coarse powder, it serves to further divide the vegetable constituents. For its mechanical effects, however, the sulphate of potassium is preferable on account of the greater hardness of its particles. Dover's powder was named from its introducer, Dr. Dover. As originally proposed by him, and as now directed in the French Codex, with but little modification, potassium nitrate and sulphate (4 parts each) were mixed in a crucible, at red heat, and cooled; sliced opium (1 part) was added and thoroughly rubbed to a powder, after which ipecacuanha and liquorice, both powdered (1 part each), were incorporated with the other ingredients. Dover's powder is a light-brown powder, having the odors of both opium and ipecac, and a bitterish and nauseous taste.
Action, Medical Uses, and Dosage.—Dover's powder, according to the dose administered, is an excellent stimulant, sedative, anodyne, and narcotic. It has a better action than either of its chief ingredients administered separately. It is a very good agent to improve the quality of the skin, the necessary moisture being induced by the ipecac to ensure the favorable action of opium, for the specific indication for the latter is a moist skin and tongue, and soft, open pulse. As a pain-relieving agent and to promote sleep, it may be used where opium alone would not be tolerated. Though profuse perspiration may be produced by it, it is also capable of checking that secretion as shown by the favorable action of 5-grain doses of the powder given to control the colliquative sweats of phthisis. It should be given a half hour before the sweating begins. Dover's powder sometimes causes sickness at the stomach, and should never be followed immediately after its administration with warm drinks, but they may be used later, if desired. As a pain-reliever, or stimulant to the internal organs, or as a hypnotic, it is admissible when there is no nausea., inflammation of the brain, or high temperature. It is an efficient drug in rheumatism, the incipient stage of inflammations, and to control cough. Hot applications to the abdomen and 5-grain doses of Dover's powder with 1 grain of camphor, every ½ or 1 hour, give marked relief in dysmenorrhoea. Without the camphor, it is very efficient in amenorrhoea from cold, being used together with external heat. It allays nervous excitation in cases of abortion, and assists in controlling uterine and pulmonary hemorrhages; 2 or 3 grains of the powder, with a like quantity of quinine, forms an efficient treatment in neuralgia, with hot, dry skin. In dysentery, it assists the action of other remedies, as well as controlling peristaltic movements, while in irritative diarrhoea, after a mild laxative, it controls any spasmodic bowel complications that may supervene. It may be used in enteritis, both to control the inflammation and the movements of the bowels. It is useful in the early stage of renal catarrhal inflammations and in granular degeneration of the kidneys, chiefly for the purpose of maintaining a good circulation and a moist condition of the skin. Dose, 2 to 10 grains, preferably in capsules.