Latin, Ipecacuanha (Gen., Ipecacuanha)

Eng., Ipecac. The dried root to which may be attached a portion of the stem of Cepha-elis ipecacuanha:, or Cephaelis acuminata.

Principal Constituents

Emetine (1 to 2 per cent.), Tannic Acid, etc.

Average Dose

Expectorant, 1 grain (0.06 Gm.). Emetic, 15 grains (1 Gm.).

Official Preparations and Alkaloid.

Fluidextractum Ipecacuanhae

Eng., Fluidextract of Ipecac.

Average Dose

Expectorant, 1 minim (0.05 mil). Emetic, 15 minims (1 mil).

Pulvis Ipecacuanhae et Opil-See Opium, p. 239.

Syrupus Ipecacuanhae

Eng., Syrup of Ipecac. Represents 7 per cent. of Ipecac. Contains some free Acetic Acid.

Average Dose

Expectorant, 15 minims (1 mil). Emetic, 4 fluidrachms (15 mils).

Emetinae Hydrochloridum (Gen., Emetinae Hydrochloridi)

Eng., Emetine Hydrochloride. The hydrochloride of an alkaloid obtained from ipecac.

Form

A white or very slightly yellowish crystalline powder.

Odor And Taste

Odorless. Not given by mouth.

Solubility

Freely soluble.

Average Dose

Hypodermic, 1/3 grain (0.2 Gm.).

Therapeutic Action

Emetic, expectorant, diaphoretic.

Uses

Coughs, bronchitis, pneumonia, amebic dysentery and liver abscesses, etc. A valuable emetic for acute indigestion, croup, poisoning, etc. A constituent of many purgative formulae.

Administration

Emetine Hydrochloride, the Syrup of Ipecac, and the Powder of Ipecac and Opium are the forms most commonly used.

The expectorant dose as here given will often prove too large. A safe rule would probably be to make 5 minims of the syrup the maximum expectorant dose till the tolerance of the patient is known.

1 Ruhrah: Diseases of Children.

Emetine Hydrochloride is administered by needle, usually injected deep into the deltoid muscle, where it seems much less apt to cause local trouble than if put under the skin. The aseptic ampoules are the form of choice. They are supplied to contain the various doses in common use.

The following prescriptions illustrate some methods of prescribing:

As an emetic:

Sig

Tablespoonful every fifteen minutes till effect. For children, as in the treatment of spasmodic croup, a teaspoonful would be given.

In expectorant preparations (for child 4 years old):

M.

Sig

Teaspoonful in water every two hours.

Or:

M.

Sig

Teaspoonful in water every two hours.

In the treatment of the cough of measles:.

M.

Sig

Teaspoonful in water every two hours.

1 Anders: Practice of Medicine.

In a laxative preparation for tuberculosis:

M. ft. cap. no. xxiv. Sig.-One at night In the interval treatment of spasmodic laryngitis of childhood:

M.

Sig

Teaspoonful in water every two hours.

In the treatment of amebic dysentery, while Emetine Hydrochloride is employed by needle, it is often considered desirable to give ipecac by mouth. The freshly prepared, salol-coated pills, are usually considered more desirable, and may be ordered as follows:

Ft. pil. enter, no. L.

Sig

Ten (10) at night as directed.

Written instructions should be left with patient, giving detailed information.

Some prefer to give full doses each time the pills are administered, some to begin with a large dose and gradually decrease.

Particular care should be exercised that the pills are properly coated. If the coating is too thick they may pass through the intestinal tract without change; if too thin or incomplete, some of the ipecac may be liberated in the stomach and violent emesis occur. The diarrhea often charged to ipecac in this treatment is probably often due to hard fragments of the shells of the salol coating acting as an irritating foreign body, and the patient sometimes passes those pieces having the appearance of the shells of bird-eggs.

In some cases of dysentery the peristalsis is so active that, even when properly coated, the pills are passed before the salol is dissolved. In such cases opium is. indicated, and may be administered as paregoric or the tincture an hour or two before the pills are taken.

1 Musser and Kelly: Practical Treatment.

2 Hughes: Practice of Medicine.