Editing Syrup of ipecac (section)

{{Short description|Plant-derived drug used for airway decongestion and to induce vomiting}}
{{Redirect|Ipecac}}
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{{Infobox drug
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| image = Bruine stopfles met label “TINCT. IPECAC.”, objectnr 40295-A-B.JPG
|caption=Flask for [[tincture]] of ipecac (ipecac roots and [[rhizome]]s dissolved in alcohol, which is watered down and sweetened to make syrup of ipecac)
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| CAS_number = 8012-96-2
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| UNII = 62I3C8233L
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| ATC_suffix = CA04
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| routes_of_administration = Oral
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'''Syrup of ipecac''' ({{IPAc-en|ˈ|ɪ|p|ᵻ|k|æ|k|audio=LL-Q1860 (eng)-Flame, not lame-Syrup of ipecac.wav}}), or simply '''ipecac''', is a drug that was once widely used as an [[expectorant]] (in low doses) and a rapid-acting [[emetic]] (in higher doses). It is obtained from the dried [[rhizome]] and [[root]]s of the ipecacuanha plant (''[[Carapichea ipecacuanha]]''), from which it derives its name. It is no longer regularly used in medicine.

In particular, the rapidly induced [[projectile vomiting|forceful vomiting]] produced by ipecac was considered for many years to be an important [[first aid|front-line]] treatment for orally ingested [[poisons]]. However, subsequent studies (including a comprehensive 2005 [[meta-study]]) revealed the stomach purging produced by ipecac to be far less effective at lowering total body poison concentrations than the [[adsorption]] effect of oral [[Activated charcoal (medication)|activated charcoal]] (which is effective through the entire gastrointestinal tract and is often coupled with [[whole bowel irrigation]]). Ipecac also presents a small risk of [[overdose]] (being a mild poison itself) and a major risk of [[esophagitis]] and [[aspiration pneumonia]] if used to purge [[corrosive]] poisons. Having long been replaced (even in the emetic role) by more effective medications, the [[American Society of Health-System Pharmacists]] (ASHP) now advises that "Ipecac syrup is no longer recommended for routine management of outpatient ingestions of medications or other chemicals."<ref>{{cite web | url = http://www.ashp.org/menu/DrugShortages/DrugsNoLongerAvailable/Bulletin.aspx?id=468 | work = Discontinued Drug Bulletin | title = Ipecac Syrup | access-date = 2014-12-16 | archive-date = 2014-12-16 | archive-url = https://web.archive.org/web/20141216172421/http://www.ashp.org/menu/DrugShortages/DrugsNoLongerAvailable/Bulletin.aspx?id=468 | url-status = dead }}</ref>

Ipecac is commonly made from alcohol extraction of the ipecacuanha plant. The extract is commonly mixed with glycerin, sugar (syrup), and methylparaben. The active ingredients are plant alkaloids, cephaeline, and methyl-cephaeline (emetine).<ref>{{cite book |vauthors = Benzoni T, Gibson J | chapter = Ipecac | date = 31 January 2023 | title = StatPearls [Internet]. | location = Treasure Island (FL) | publisher =  StatPearls Publishing | chapter-url= https://www.ncbi.nlm.nih.gov/books/NBK448075/#:~:text=Ipecac%20is%20commonly%20made%20from,methyl%2Dcephaeline%20(emetine) | pmid=28846272 }}</ref>