Substance
Ipecac syrup or fluid extract

Pathology
Cardiac and neuromuscular toxicity with systemic absorption; toxicities are seen with chronic and prolonged use.

Symptoms
Vomiting, diarrhea, lethargy, irritability, hypothermia, hypotonia, dehydration, gastritis, seizures, cardiac toxicity, neuromuscular toxicity, shock, death.

Emergency Measures
Activated charcoal may be given if the patient is not vomiting. Supportive care includes fluid replacement, correction of electrolyte abnormalities, cardiac monitoring, and therapy for dysrhythmias.

Comments
Chronic exposures are reported in patients with eating disorders; cases of toxicity secondary to Munchausen's syndrome by proxy have also been documented.