RICHARD A. ROMIG, M.D.
To the editor: Patient 2 in the article by Isner and associates (1) deserves special comment because she had been taking ipecac syrup daily for 4 months. Ipecac contains two potent cardiotoxins, cephaeline and emetine (2). These toxic alkaloids are cumulative and slowly excreted by unknown mechanisms. Emetine may prolong the QT interval, and both alkaloids may induce atrial and ventricular arrhythmias. Sudden deaths have occurred in animals subjected to toxicity experiments (3). Fatal cardiotoxicity may occur in the absence of histopathologic findings by conventional light microscopy. The toxic alkaloids of ipecac can be considered potent direct-negative inotropic agents probably
ROMIG RA. Anorexia Nervosa, Ipecac, and Sudden Death. Ann Intern Med. ;103:641. doi: 10.7326/0003-4819-103-4-641_2
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Published: Ann Intern Med. 1985;103(4):641.
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