Syrup of Ipecac (derived from the dried rhizome and roots of the Ipecacuanha plant), is an emetic—a substance used to induce vomiting. It is used in cases of accidental poisoning, and is perhaps the best-known emetic. Ipecac is also used in cough mixtures as an expectorant and from the 18th until the early 20th century, Ipecac and opium were used to produce Dover's powder, which was used in syrup form. Ginger rhizome A rhizome is, in botany, a usually underground, horizontal stem of a plant that often sends out roots and shoots from its nodes. ... ROOT is an object-oriented software package developed by CERN. It was originally designed for particle physics data analysis and contains several features specific to this field, but it is also commonly used in other applications such as astronomy and data mining. ... Binomial name Psychotria ipecacuanha Ipecacuanha (Psychotria ipecacuanha) of family Rubiaceae is a flowering plant, the root of which is most commonly used to make syrup of ipecac, a powerful emetic. ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... The skull and crossbones symbol (Jolly Roger) traditionally used to label a poisonous substance. ... A cough medicine or antitussive is a medication given to people to help them stop coughing. ... (17th century - 18th century - 19th century - more centuries) As a means of recording the passage of time, the 18th century refers to the century that lasted from 1701 through 1800. ... (19th century - 20th century - 21st century - more centuries) Decades: 1900s 1910s 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s As a means of recording the passage of time, the 20th century was that century which lasted from 1901–2000 in the sense of the Gregorian calendar (1900–1999... This article does not adequately cite its references. ... Dovers powder was a traditional medicine against cold and fever. ...

Mechanism of action

The actions of Ipecac are mainly those of its major alkaloids, emetine (methylcephalin) and cephalin. They both act locally by irritating the gastric mucosa and centrally by stimulating the medullary chemoreceptor trigger zone to induce vomiting.^[1] Chemical structure of ephedrine, a phenethylamine alkaloid An alkaloid is, strictly speaking, a naturally occurring amine produced by a plant,[1] but amines produced by animals and fungi are also called alkaloids. ... Cephalin is a phospholipid, which is a lipid derivative. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ...

Dosage

In children up to six months of age:

Ipecac syrup should only be administered under the supervision of a physician

Children 6–12 months of age:

5 to 10 mL (1 to 2 teaspoons) preceded or followed by 120 to 240 mL (½ to 1 cup) of water

Children 1–12 years of age: The litre or liter (see spelling differences) is a unit of volume. ... Image:Teaspoon sugar. ... A simple plastic measuring cup A measuring cup is a kitchen utensil used to measure liquid or dry substances when cooking. ...

15 mL (1 tablespoon) preceded or followed by 120 to 240 mL (½ to 1 cup) of water

Adolescents and adults: This tablespoon has a capacity of about 1 tbsp. ...

15 to 30 mL (1 to 2 tablespoon) followed immediately by 240 mL (1 cup) of water.

Vomiting typically happens within 15 to 20 minutes. If the patient has not vomited within 20 to 30 minutes, a second dose can be administered.^[1] Saving the vomit is recommended for medical inspection.

Use

Though it has a long history of use, syrup of Ipecac has come under recent scrutiny.^[1] In cooking, a syrup (from Arabic شراب sharab, beverage, via Latin siropus) is a thick, viscous liquid, containing a large amount of dissolved sugars, but showing little tendency to deposit crystals. ...

One recent scientific review (2005) by an expert panel concluded that vomiting alone does not reliably remove poisons from the stomach. The study suggested that indications for use of Ipecac syrup were rare and patients should be treated by more effective and safer means. Additionally, Ipecac’s potential side effects, such as lethargy, can be confused with the poison’s effects, complicating diagnosis. Ipecac may also delay the administration or reduce the effectiveness of other treatments such as activated charcoal, whole bowel irrigation, or oral antidotes.^[2] The current first-line treatment for most ingested poisons is now activated charcoal, which operates much more quickly and effectively than Ipecac treatment.^[3] In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... Fatigue is a feeling of excessive tiredness or lethargy, with a desire to rest, perhaps to sleep. ... In general, a diagnosis (plural diagnoses) has two distinct dictionary definitions. ... Activated carbon (also called activated charcoal) is the more general term which includes material mostly derived from charcoal. ... Whole bowel irrigation (WBI) is a medical process involving the rapid administration of large volumes of an osmotically balanced polyethylene glycol solution (GoLYTELY®, CoLyte®), either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract. ... An antidote is a substance which can counteract a form of poisoning. ...

Although Ipecac was once recommended by pediatricians to be kept in the home, the current guidelines from the American Academy of Pediatrics recommends against keeping syrup of Ipecac in the home and in fact recommends disposal of any syrup of Ipecac present in the home.^[4] Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. ... The American Academy of Pediatrics (AAP) is an organization of pediatricians. ...

The reason for this new policy was:

1. There was no evidence that syrup of Ipecac actually helps improve the outcome in cases of poisoning
2. Administering syrup of Ipecac can delay administering more effective treatments, such as activated charcoal and/or antidotes
3. Syrup of Ipecac can change neurologic status, and so the effects of the Ipecac can be mistaken for the effects of the poisoning
4. Accidental overdose of Ipecac can result when administered in the home
5. Universal availability of Ipecac in the home may have contributed to Ipecac abuse by bulimics and intentional misuse of Ipecac in cases of Munchausen syndrome by proxy.

Fabricated or Induced Illness (FII) is the formal name of a type of abuse in which a caregiver feigns or induces an illness in a person under their care, in order to attract attention, sympathy, or to fill other emotional needs. ...

Abuse

Ipecac has been used by individuals with bulimia nervosa as a means to achieve weight loss. Repeated abuse is believed to cause damage to the heart, which can ultimately result in the user's death.^[5] It can also destroy teeth due to long term contact with stomach acid, as what generally happens in bulimics. The death of singer Karen Carpenter in 1983 has been popularly attributed to her abuse of Ipecac for weight control. Bulimia nervosa, commonly known as bulimia, is an eating disorder. ... This article needs additional references or sources for verification. ... The Carpenters were a vocal and instrumental duo, consisting of siblings Karen and Richard Carpenter. ...

See also

• Algarot
• Defensive vomiting

This article or section may be confusing or unclear for some readers, and should be edited to rectify this. ... Defensive vomiting is a symptom of anorexia nervosa and bulimia nervosa in which a person who has drastically over-eaten (generally in reaction to previous extreme dieting) vomits as a reaction to an excess of food which the body is not prepared to handle. ...

Footnotes

External links

• MedlinePlus Drug Information
• AAP policy on Poison Treatment in the Home
• Guy drinks Ipecac and puke in public