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At least 19 recordsLinked to original sources
PubMed1977

Toxicology of ipecac: a review.

The general effectiveness and safety of Ipecac syrup, per se, has not been questioned, but rather an attempt has been made to consolidate pertinent literature dealing with the toxic manifestations of Ipecac fluid extract. Ipecac contains both emetine and cephaeline and the toxicity of Ipecac fluid extract is consistent with reports on the toxicity of both compounds. The majority of the work has involved emetine since it is in higher concentration in Ipecac fluid extract than is cephaeline. Comparison of the clinical picture presented in syrup or fluid extract of Ipecac overdose and emetine toxicity in amebiasis treatment permits us to summarize the general characteristics of Ipecac alkaloid toxicity as involving primarily gastrointestinal, cardiovascular, and neuromuscular foci.

Adult↗
PubMed1976

A clinical comparison of syrup of ipecac and apomorphine use in adults.

A prospective, randomized study was performed to compare syrup of ipecac to apomorphine as the emetic of choice in poisoning cases. Of the 28 adults studied, 15 patients (54%) received 30 ml of ipecac orally and 13 received 0.1 mg/kg apomorphine subcutaneously. Emesis was successfully induced with initial therapy in 13 of 15 (87%) ipecac-treated patients and 10 of 13 (77%) apomorphine-treated patients. In the ipecac group the mean latency period before onset of vomiting was 11.6 minutes (range 4 to 26 min) and in the apomorphine group, 5.3 minutes (range 2 to 13 min) (P less than .01). In the ipecac group, one patient suffered moderate central nervous system (CNS) depression. No hypotension or respiratory depression was observed in this group. In the apomorphine group significant CNS depression developed in eight patients (62%), hypotension developed in five (38%) and respiratory depression in one. There was no consistent relationship between type of poison ingested and occurrence of side effects.

Adolescent↗
PubMed1978

Rapid emesis from high-dose ipecac syrup in adults and children intoxicated with antiemetics or other drugs.

The effect of ipecac syrup as an emetic in adults as well as children who had ingested antiemetics or other drugs was evaluated. Adults or children over five years of age were given 30 ml of ipecac syrup followed by 360 ml of water; children aged one to five years were given 15 ml ipecac syrup followed by 240 ml of water. If emesis was not induced within 30 minutes, a second dose was administered. Of 232 patients studied (199 adults and 33 children), 188 (81%) vomited following the first dose, 34 (15%) required two doses and seven (3%) did not vomit. Of 63 patients who had ingested drugs with antiemetic properties, 51 (81%) vomited following the first dose, nine (14%) required a second dose and three (5%) did not vomit. The time from ipecac administration to the onset of emesis in all 232 patients averaged 24.2 minutes. Ipecac was successful in inducing rapid emesis in both adults and children who had ingested antiemetics or other drugs, probably as a result of its irritating effect on the gastric mucosa.

Adolescent↗
PubMed1992

Ipecac abuse--danger.

Ipecac abuse must be considered when working with individuals at risk, particularly those with eating disorders. Medical complications such as myopathy and gastrointestinal and other toxic effects can occur with ipecac abuse, the gravity of which must not be underestimated. Education about ipecac abuse and toxicity is extremely important. Discontinuation of ipecac use usually results in recovery from the harmful effects. College healthcare professionals can play an important role in the education and treatment of this potentially hazardous method of weight control.

Bulimia↗
PubMed1991

Hemorrhagic colitis and pseudomelanosis coli in ipecac ingestion by proxy.

This report describes a toddler with chronic diarrhea, vomiting, and hypotonia due to surreptitious administration of syrup of ipecac by his mother (Munchausen's syndrome by proxy). Several features of this case distinguish it from previous reports of chronic ipecac ingestion in childhood: the development of grossly bloody stools; radiologic, endoscopic, and biopsy evidence of a chronic moderate colitis resembling ulcerative colitis; and the histologic finding of pseudomelanosis coli, providing an important clue to toxic ingestion. The significance and possible mechanism for genesis of pseudomelanosis coli is discussed. This case emphasizes the variability in presentation and difficulty in diagnosing long-term ipecac ingestion by proxy. Ipecac toxicity should be considered in children with unexplained colitis and vomiting.

Biopsy↗
PubMed1990

Efficacy of emetic and United State pharmacopoeia ipecac syrup in prevention of drug absorption.

The efficacy of both the emetic syrup prepared in the previous report and the United States Pharmacopoeia (USP) ipecac syrup concerning the prevention of drug absorption was investigated in 4 beagle dogs using a randomized and cross-over design. In order to control the intragastric pH of the beagle dogs, the administration of pentagastrin or hydrochloric acid (HCl)-glycine buffer (pH 1.5) was tested. The intragastric pH changed from 7.2 to 1.8 with the intramuscular administration of pentagastrin, but the primary emesis occurred more slowly. On the other hand, the HCl-glycine buffer (pH 1.5) gave the appropriate emesis. Therefore, the HCl-glycine buffer (pH 1.5) was used to control the intragastric pH of the beagle dogs. Acetaminophen (AcA), salicylic acid (SA) and kanamycin (KM) as markers were administered orally after conditioning the intragastric pH at 1.5. The emetic syrup or the USP ipecac syrup was then administered. The recovery rate of AcA and KM from vomit was 42-65%. The emetic syrup and the USP ipecac syrup significantly reduced the absorption of AcA from the calculation of pharmacokinetic parameters compared to the control syrup. It was observed that the absorption of cephaeline (CP) in the emetic syrup was less than that of CP in the USP ipecac syrup.

Absorption↗
PubMed1991

The effect of milk on ipecac-induced emesis.

A prospective study at two regional poison centers was undertaken in 500 children under six years of age (mean age 2.3 y) to resolve the question of whether milk has an effect on ipecac-induced emesis. When home administration of ipecac was recommended, parents were asked to select either milk or clear fluids. The mean volume of fluid +/- standard deviation administered was 159 +/- 72 mL in the milk group and 161 +/- 77 mL in the clear fluid group (p = 0.79). There was no difference in the onset of vomiting (23.4 +/- 18.5 vs. 23.3 +/- 12.9 min, p = 0.92), number of vomiting episodes (3.5 +/- 1.9 vs. 3.4 +/- 1.8, p = 0.65), or duration of vomiting (45 +/- 73 vs. 39 +/- 54 min, p = 0.31) for the milk group compared with the clear fluid group. Side effects including lethargy and diarrhea occurred with similar frequency in both groups. The substance ingested had no effect on onset of vomiting, vomiting duration or number of vomiting episodes. These findings again demonstrate that milk does not interfere with ipecac-induced emesis.

Animals↗
PubMed1978

In vitro evidence for ipecac inactivation by activated charcoal.

The in vitro adsorption of the alkaloid emetine, a primary constituent of ipecac, on activated charcoal was studied. The results support the supposition that syrup of ipecac should not be given to counteract poisonings if activated charcoal is also to be administered.

Adsorption↗
PubMed1991

Pediatric ingestions: charcoal alone versus ipecac and charcoal.

STUDY OBJECTIVES: To determine the effect of syrup of ipecac (SOI) on time to receive and retention of activated charcoal (AC) and on total ED time. DESIGN: During a two-year period, patients were enrolled in a prospective, randomized, unblinded, controlled trial. SETTING: All patients were recruited and studied in a pediatric emergency department. PARTICIPANTS: Seventy children less than 6 years old (mean age, 2.4 +/- 0.2 years) who presented with mild-to-moderate acute oral ingestions. INTERVENTIONS: Group 1 received SOI before AC. Group 2 received only AC. MEASUREMENTS AND MAIN RESULTS: Group 1 patients took significantly longer to receive AC than group 2 from the time of ED arrival (2.6 +/- 0.1 vs 0.9 +/- 0.1 hours, P less than .0001). Group 1 children were significantly more likely to vomit AC than were group 2 children (18 of 32 vs six of 38, P less than .001). Patients receiving SOI who were subsequently discharged spent significantly more time in the ED than those receiving only AC (4.1 +/- 0.2 vs 3.4 +/- 0.2 hours, P less than .05). CONCLUSIONS: Ipecac delays the administration of AC, hinders its retention, and prolongs ED time in pediatric ingestion patients. These data support the recommendation that AC alone should be the gastrointestinal decontamination method of choice for the mild-to-moderate pediatric ingestion patient presenting to an ED.

Charcoal↗
PubMed1977

[Partial disorganization of the anaphasic segregation of chromosomes in plant cells: combined actions of griseofulvin, producer of pluripolar anaphases and 2 ipecac alkaloids, producers of floating pole anaphases].

Anaphasis may be slightly checked by various treatments which however result in a normal chromosomic separation. Griseofulvin exerts a direct though partial influence on the mitotic apparatus, which entails "pluripolar anaphasis"; on the other hand Ipecac alkaloïds act indirectly and produce "floating poles anaphases". Treatments combining griseofulvin with cepheline or tubulosine show that there is never any synergy between the two processes. These results support our hypothesis that floating poles anaphases are not a sign of slight C-mitotic action but only come from a lag between the appearance/disappearance of microtubules and that of chromosomes during anaphasis.

Anaphase↗
PubMed1992

Treating poisonings: focus on syrup of ipecac.

The awareness of poison prevention is increasing despite an alarming incidence of accidental and intentional poisonings in the United States. During 1990, 72 poison centers throughout the United States, serving a population of 191.7 million, submitted to the American Association of Poison Control Centers data collection system 1,713,462 cases of poisonings, which included 612 deaths. Emetic agents, when used properly, can reduce the extent and severity of improperly ingested medications, selected household products, and other toxic chemicals. The pharmacist can play a valuable role in distributing information about poison control centers, poison prevention, and appropriate treatment of poisonings.

Accidents, Home↗
PubMed1976

Telephone management of poisonings using syrup of ipecac.

Seven hundred and seventy-six cases were studied during a six-month period to see if induction of emesis could be successfully managed at home by telephone. Emesis was successful in 98.8% of cases. In 6.7% of all cases, symptoms were found at 4-hour follow-up that were referrable to the ingestion, but all were considered to be of minor consequence. No complications of vomiting occurred. Twenty-four hour follow-up investigation indicated no significant complications of induction of emesis or complications from managing the patient by telephone. It is our conclusion that, with appropriate telephone supervision, home-induced emesis of ingestions expected to produce mild to moderate symptoms is as effective as emergency room or physician office management of cases. Furthermore, the absence of adverse affects of complications arising from the induction of emesis at home in our cases confirms that this form of management is quite safe.

Adolescent↗