The phytochemical analysis of Ipecac root has shown that the roots of this plant are composed of the major ingredients of the alkaloids emetine and cephaeline. The root also contain tannins, flavonoids, saponins, polyphenols, triterpenoids and small amount of anthrax quinine glycosides.5
            The alkaloids have several important actions, including activation of brain centres that can induce vomiting, slowing down the sympathetic nervous system and also slowing down protein synthesis.6

            The Ipecac syrup is generally used for treating an individual who took poison. To most people, taking Ipecac in sufficient amounts leads to instant vomiting within 30 minutes. The protein-inhibiting effects of emetine and other alkaloids of Ipecac root are responsible for the ability of the plant to inhibit growth or kill several types of parasites, including pinworms and tapeworms.
However, excess intake of this ipecac root by individual can lead to serious side effect. 8

            Brazilian and Indians appreciated Ipecac as a medicine for dysentery and this data was transferred to Europe by Portugueas disciples.
            Emetine, derived from the root that has been used for more than a century to treat dysentery. The dried Ipecac root and rhizome are the source of therapeutically useful products. Ipecac root has been extensively used in syrup to form as a potent and effective emetic. Ipecac powder had been used to persuade or induce sweating, at the beginning of influenza and, the tiny quantities of the extract have been included into cough syrups as expectorants. 11

Heavy or over usage of emetine can carry the risk of developing proximal myopathy or cardiomyopathy.9
            The emetine has trigger vomiting through an angrevation action on the intestinal mucosa and produces impulse vomiting and diarrhea. Emetine mainly has a central action on the chemoreceptor active region, the syrup stimulates vomiting in 15-60 minutes an is most effective when taken along with fluids.12 There are different opinions about the use of Ipecac. While there may be a benefit in some poisoning cases, a study predicates that there was no obvious benefit when Ipecac syrup was used at home. 13
            Therefore, there will be maximum benefit, if Ipecac is taken immediately after the poison ingestion. Once a recommended Ipecac had been kept ready for the purpose of an accidental poisoning, the current guideline from American Academy of pediatrics strongly advised against this and infact they recommended the disposal of any ipecac syrup present at home. 14

            Ipecac has been used by individuals with bulimia nervosa a means to achieve weight loss through induced defensive vomiting, repeated abuse is believed to cause damage to the heart, which can ultimately result in the user’s death.15
            Ipecac abuse has been blamed for the death of well known singer or musician Karen carpenter in 1983. It has also been used as an agent for Munchausen’s syndrome by proxy. 16

            Rio Ipecac, this is in pieces 2.4 to 4mm thick variously bent and contorted simple or branched, consisting of an interior, light straw-coloured, ligneous cord, with a thick brittle, brownish, finely wrinkled, cortical covering, which is present on it’s surface, a succession of circular, unequal, prominent rings or rugae, separated by very narrow tissues, frequently extending nearly down to the central fiber. 17
            This appearance of the surface has given rise to the term annele, or annulated, by which the true Ipecac is designated by French pharmacists. The cortex is hard, horny, and semi-transparent. Which break with a resinous fracture and easily separates from the tougher ligneous fibres which passes the medicinal virtues of the root in a much inferior degree. 18
            On microscopic examination the very thick bark is seen to be formed of uniform parenchymatous cells, without traces of the medullary rays, which are very distinct in the woody central cylinder attached to the roots is frequently a smoother and more slender portion, which is the base of the stem and it should be separated before pulverization.
            Much stress has been laid upon the colour of the external surface of the Ipecac root, and diversity in this respect has been led to the formation of distinct varieties.
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