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ipecac (emetine, cephaeline)
Dried root of a shrub found in Brazil (Cephaelis ipecacuanha)
Indications:
- used to induce vomiting in the early management of some, but not all, oral drug overdoses & poisoning
Contraindications:
1) age < 6 months
2) absence of gag reflex
3) CNS depression or ingestion of CNS depressant
4) ingestion of caustic or acidic substance
5) NOT recommended for household use [2,3]
Dosage:
1) give with adequate hydration (give with clear liquid)
2) adults & children > 12 years: 30 mL x 1
3) children 1-12 years: 15 mL x 1
Pharmacokinetics:
1) 90% of patients vomit within 30 minutes
2) average time to vomiting is 20 minutes
3) average duration of action 60 minutes
Adverse effects:
1) protracted vomiting
2) diarrhea
3) lethargy
4) cardiac toxicity with chronic use (bulimia) [2]
Overdose: see [4]
Mechanism of action:
1) acts centrally & locally
2) stimulation of the medullary chemoreceptor trigger zone (CTZ)
3) irritates gastric mucosa
4) stimulates vomiting
General
alkaloid
emetic
Properties
MISC-INFO: pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
Kegg map/map00901
References
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
Department of Veterans Affairs, VA National Formulary
- Prescriber's Letter 10(12):67 2003
- Journal Watch 23(24):190, 2003
Bond GR, Pediatrics 112:1061, 2003
PMID: 14595046
Shannon M, Pediatrics 112:1180, 2003
PMID: 14595066
American Academy of Pediatrics Committe on Injury, Violence,
& Poison Prevention, Pediatrics 112:1182, 2003
PMID: 14595067
- Deprecated Reference
Components
cephaeline (cephaelin)
emetine (emetin)