Ultrastructural pathology in emetine-induced myopathy

Halbig, L.; Gutmann, Ludwig; Goebel, Hans H.; Brick, John; Schochet, Sydney S.

doi:10.1007/bf00686202

Cited by 34 publications

(13 citation statements)

References 15 publications

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“…Several complications regarding intoxication related to misuse of ipecac extract or syrup preparation have been described 6,7,8). Chronic abuse of ipecac syrup by bulimic patients in order to induce vomiting may lead to the development of cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

Absorption, distribution and excretion of3H-labeled cephaeline- and emetine-spiked ipecac syrup in rats

Asano

Ishihara²,

Wakui³

et al. 2002

Eur. J. Drug Metab. Pharmacokinet.

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The maximum plasma radioactivity levels of tritium (3H)-labeled cephaeline, (24.3, 28.7 and 40.6 ng eq./mL) were reached at 2.00-3.33 hours following oral dosing of ipecac syrup. The maximum plasma radioactivity levels of 3H-emetine (2.71, 6.47 and 9.62 ng eq./mL) were reached at 1.08-2.33 hours following ipecac syrup administration. The Cmax values of 3H-cephaeline were followed by a biexponential decrease with half-lives t 1/2(lambda z) of 3.45-9.40 hours. On the other hand, the t 1/2 (lambda z)of 3H-emetine were 65.4-163 hours, which revealed a biexponential decrease. The radioactivity of both tritium-labeled compounds was distrbuted maximally in most tissues at 24 hours. For 3H-cephaeline, the maximum radioactivity levels in tissues were approximately 100-150 times greater than in plasma. For 3H-emetine, the radioactivity levels in tissues were approximately 1000-3000 times greater than in plasma. Tissue radioactivity levels decreased at a substantially slower rate than that observed in plasma. Tissue radioactivity of 3H-emetine decreased more slowly than that of 3H-cephaeline. For 3H-cephaeline, the cumulative biliary excretion of radioactivity was 57.5% at 48 hours. The cumulative urinary and fecal excretion of radioactivity in these rats was 16.5% and 29.1%, respectively, of the dose at 48 hours following dosing. For 3H-emetine, the cumulative biliary excretion of radioactivity was 12.5% at 48 hours. The cumulative urinary and fecal excretion of radioactivity was 9.4% and 34.1%, respectively, of the administered dose at 48 hours. The radioactivity level of 3H-emetine remaining in the carcasses at 48 hours was equivalent to approximately 50% of the dose. A portion of each tritium-labeled compound was subjected to entero-hepatic circulation. Thus, the absorption rate of 3H-cephaeline and 3H-emetine was estimated to be approximately 70% on the basis of the data obtained from excretion studies. There was no difference in the absorption process between these two compounds. However, the difference was admitted in the biliary clearance, which is the main excretion route of both compounds. Delayed excretion of 3H-emetine may be primarily due to its resorption as related to entero-hepatic circulation and tissue retention. This study has determined the absorption, distribution and excretion of 3H-cephaeline and 3H-emetine in rats.

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Section: Introductionmentioning

confidence: 99%

Absorption, distribution and excretion of3H-labeled cephaeline- and emetine-spiked ipecac syrup in rats

Asano

Ishihara²,

Wakui³

et al. 2002

Eur. J. Drug Metab. Pharmacokinet.

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“…On the other hand, certain patients may have a nonfamilial, nongenetic, but acquired DRM as, for instance, those affected by intoxication with emetine or enalfide, a chemotherapeutic agent, [9] or by ipecac myopathy. [22] Hereditary inclusion body myopathies This group of disorders may be classified among the PAM because different proteins aggregate within muscle fibers, which contain autophagic vacuoles, and within tubulofilamentous aggregates which are the hallmark of inclusion body myopathies (IBM). [23] Similarities between IBM and DRM are distribution of muscle weakness, occurring later than childhood-onset of clinical symptoms.…”

Section: Pam Suggesting Faulty Protein Degradationmentioning

confidence: 99%

Protein Aggregate Myopathies

Goebel

Müller

2006

Seminars in Pediatric Neurology

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“…Pneumomediastinum and retroneuromoperitoneum have also been described [61]. The most severe injuries associated with the repeated and chronic use of Ipecac are myositis [56 -60, 63,64] and myocardial damage [24,27,29,62]. Death may result from arrhythmia or heart failure [63][64][65][66][67][68].…”

Section: Toxicitymentioning

confidence: 99%

“…The lesion spectrum ranges from "Z band streaming" to the formation of cytoplasmic bodies, including abnormalities of the sarcotubular system [62]. The classic cardiac lesion is a cardiomyopathy, which can result in an enlarged heart.…”

Section: Toxicitymentioning

confidence: 99%

“…Symptoms initially may be nonspecific and underreported. The prominent symptoms of chronic use are intractable vomiting, diarrhea, hemorrhagic colitis, muscular weakness, cardiac failure, and arrhythmias [55][56][57][58][59][60][61][62][63][64][65][66][67][68].Frequently users will be denying the seriousness of the symptomatology or will not see the connection between their use of ipecac and feeling sick. Some, who understand what is happening to them, may still lie about it, in their unshakable conviction that "I'd rather be dead than fat."…”

Section: Clinical Characteristics Morbidity and Mortalitymentioning

confidence: 99%

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