LITERATURE REVIEW
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
THE
USES OF IPECAC ROOT
CUSTOMARY
USES
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
ADVERSE
REACTIONS OF EMETINE.
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
ABUSE
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
PROPERTIES
OF IPECAC ROOT
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.