Syrup of Ipecac—A Slow or Fast Emetic?

Emesis with Ipecac For centuries, ipecac has been known to induce emesis; for years, it has been used in the emergency treatment of accidental ingestions of poison. Prior to 1957, however, surprisingly little data were available to document ipecac's efficacy in the treatment of accidental poisonings. At that time, Arnold et al. 1 provided the first convincing evidence of ipecac's effectiveness, pointing out, in the process, the superiority of ipecacinduced emesis over gastric lavage in ridding the stomachs of dogs of ingested acetylsalicylic acid (aspirin). Nevertheless, controversy persists concerning the advisability of the use of ipecac. Certainly ipecac is less time-consuming and more convenient to use than is gastric lavage—possibly accounting for its popularity in many poison control centers. Objections to it focus on ( a ) the reported long delay between administration of ipecac and onset of emesis; ( b ) the possibility of aspiration during emesis, and ( c ) the potential toxicity. This