Summary: Agents that cause vomiting. They may act directly on the gastrointestinal tract, bringing about emesis through local irritant effects, or indirectly, through their effects on the chemoreceptor trigger zone in the postremal area near the medulla.

Top Publications

  1. Heard K. The changing indications of gastrointestinal decontamination in poisonings. Clin Lab Med. 2006;26:1-12, vii pubmed
    ..Although the practice is widely accepted, the science behind the recommendations is limited. This article describes commonly used techniques for GI decontamination and critically reviews the studies evaluating these treatments. ..
  2. Parker L, Limebeer C. Conditioned gaping in rats: a selective measure of nausea. Auton Neurosci. 2006;129:36-41 pubmed
    ..The conditioned gaping reaction can be used as a pre-clinical tool to evaluate the side effects of nausea that might result from newly developed pharmaceutical agents. ..
  3. van Haastrecht J. [Measures to reduce absorption in the treatment of intoxications]. Ned Tijdschr Geneeskd. 2006;150:585; author reply 585-6 pubmed
  4. de Vries I, van Zoelen G, van Riel A, Meulenbelt J. [Measures to reduce absorption in the treatment of intoxications]. Ned Tijdschr Geneeskd. 2005;149:2964-8 pubmed
    ..Only ifdefaecation is insufficient should administration of a laxative together with activated charcoal be considered. ..
  5. Andrews P, Kovacs M, Watson J. The anti-emetic action of the neurokinin(1) receptor antagonist CP-99,994 does not require the presence of the area postrema in the dog. Neurosci Lett. 2001;314:102-4 pubmed
  6. Makale M, King G. Surgical and pharmacological dissociation of cardiovascular and emetic responses to intragastric CuSO4. Am J Physiol. 1992;263:R284-91 pubmed
    ..In another series of experiments, a significantly greater proportion of animals vomited in response to intragastric CuSO4 than to intraduodenal CuSO4, suggesting that the primary site of CuSO4 action in the ferret is the stomach. ..
  7. Yamamoto K, Ngan M, Takeda N, Yamatodani A, Rudd J. Differential activity of drugs to induce emesis and pica behavior in Suncus murinus (house musk shrew) and rats. Physiol Behav. 2004;83:151-6 pubmed
    ..Conversely, all treatments induced kaolin consumption in rats without inducing emesis. The results indicate that pica behavior is not likely to be useful to assess gastrointestinal discomfort in S. murinus. ..
  8. Horn C, De Jonghe B, Matyas K, Norgren R. Chemotherapy-induced kaolin intake is increased by lesion of the lateral parabrachial nucleus of the rat. Am J Physiol Regul Integr Comp Physiol. 2009;297:R1375-82 pubmed publisher
    ..These data suggest that lPBN-lesioned animals not only demonstrate pica after cisplatin treatment, but, in fact, show an exaggerated response that is greatly in excess of any treatment known to produce kaolin intake in rats...
  9. Kelly B. Dr William Saunders Hallaran and psychiatric practice in nineteenth-century Ireland. Ir J Med Sci. 2008;177:79-84 pubmed
    ..systematic engagement with causes, courses, outcomes; (d) reconsideration of traditional treatments (venesection, emetics, purgatives); (e) exploration of novel approaches (Dr Cox's Circulating Swing); and (f) re-evaluation of ..

More Information


  1. Jääskeläinen E, Teplova V, Andersson M, Andersson L, Tammela P, Andersson M, et al. In vitro assay for human toxicity of cereulide, the emetic mitochondrial toxin produced by food poisoning Bacillus cereus. Toxicol In Vitro. 2003;17:737-44 pubmed
    ..Spermatozoa in commercially available extended fresh boar and cryopreserved bull semen were compared, boar sperms were 100 times more sensitive to cereulide than bull sperms. ..
  2. Koga T, Kobashi M, Mizutani M, Tsukamoto G, Matsuo R. Area postrema mediates gastric motor response induced by apomorphine in rats. Brain Res. 2003;960:122-31 pubmed
    ..In conclusion, rats showed definitive autonomic phenomena in response to the administration of apomorphine. Dopamine 2-like receptors situated in the AP mediate apomorphine-induced autonomic phenomena in rats. ..
  3. Keifenheim K, Giel K, Leehr E, Becker S, Mörike K, Zipfel S, et al. [Difficulties in adressing purging behaviour in the treatment of a patient with anorexia nervosa]. Dtsch Med Wochenschr. 2013;138:1670 pubmed publisher
    ..However, purging behaviour can be very dangerous to one's health. Using a hCG diet (Hollywood diet) is a rare purging method in patients with anorexia nervosa. ..
  4. Singh V, Garcia M, Seed T. A review of radiation countermeasures focusing on injury-specific medicinals and regulatory approval status: part II. Countermeasures for limited indications, internalized radionuclides, emesis, late effects, and agents demonstrating efficacy in larg. Int J Radiat Biol. 2017;93:870-884 pubmed publisher
    ..There is a limited number of countermeasures which are progressing well following the Animal Rule and may get approved in the near future, thus serving to close the gap of this critically important, unmet radiobiomedical need. ..
  5. Tarabar A, Khan Y, Nelson L, Hoffman R. Antimony toxicity from the use of tartar emetic for the treatment of alcohol abuse. Vet Hum Toxicol. 2004;46:331-3 pubmed
    ..It is important to recognize that foreign alcohol therapies aversive therapy other than disulfiram may be used, the contents of such a foreign product should be identified. ..
  6. McCormick J, Bohach G, Schlievert P. Pyrogenic, lethal, and emetic properties of superantigens in rabbits and primates. Methods Mol Biol. 2003;214:245-53 pubmed
  7. Franke S, Pra D, da Silva J, Erdtmann B, Henriques J. Possible repair action of Vitamin C on DNA damage induced by methyl methanesulfonate, cyclophosphamide, FeSO4 and CuSO4 in mouse blood cells in vivo. Mutat Res. 2005;583:75-84 pubmed
    ..Further data is needed to shed light upon the beneficial/noxious effects of VitC. ..
  8. Hasegawa M, Sasaki T, Sadakane K, Tabuchi M, Takeda Y, Kimura M, et al. Studies for the emetic mechanisms of ipecac syrup (TJN-119) and its active components in ferrets: involvement of 5-hydroxytryptamine receptors. Jpn J Pharmacol. 2002;89:113-9 pubmed
    ..These results suggest that 5-HT3 receptor plays an important role in the emetic action of TJN-119, cephaeline and emetine, and the 5-HT4 receptor may be involved in their mechanisms. ..
  9. Puschel K, Bachmann D. Proving possession of drugs in so-called body stuffers. J Forensic Leg Med. 2007;14:96-8 pubmed
    ..This method has proved to be safe and successful as drugs were recovered in nearly two-thirds of the cases. The offenders were predominantly male Africans 16-25 years old. ..
  10. Guay D, Hamel P, Blouin M, Brideau C, Chan C, Chauret N, et al. Discovery of L-791,943: a potent, selective, non emetic and orally active phosphodiesterase-4 inhibitor. Bioorg Med Chem Lett. 2002;12:1457-61 pubmed
  11. Bond G. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med. 2002;39:273-86 pubmed
    ..these patients, individual physicians must act on a personal valuation: Is it better to use a treatment that might have some benefit but definitely has some risk or not to use a treatment that has any risk unless there is proven benefit? ..
  12. Thorsen L, Hansen B, Nielsen K, Hendriksen N, Phipps R, Budde B. Characterization of emetic Bacillus weihenstephanensis, a new cereulide-producing bacterium. Appl Environ Microbiol. 2006;72:5118-21 pubmed publisher
    ..The strains are atypical with regard to pheno- and genotypic characteristics normally used for identification of emetic B. cereus strains. MC67 and MC118 produced cereulide at temperatures of as low as 8 degrees C...
  13. Sharkey K, Cristino L, Oland L, Van Sickle M, Starowicz K, Pittman Q, et al. Arvanil, anandamide and N-arachidonoyl-dopamine (NADA) inhibit emesis through cannabinoid CB1 and vanilloid TRPV1 receptors in the ferret. Eur J Neurosci. 2007;25:2773-82 pubmed
  14. Kelly N, Sanchez S. Is syrup of ipecac still for sale? Comparison of pharmacies in a large urban area--2003 versus 2005. Clin Pediatr (Phila). 2007;46:320-4 pubmed
    ..27). Although syrup of ipecac availability has declined significantly, it is still available in more than 50% of pharmacies. Health care providers should advise against its use and advocate that pharmacies remove it. ..
  15. Altayar M, Sutherland A. Bacillus cereus is common in the environment but emetic toxin producing isolates are rare. J Appl Microbiol. 2006;100:7-14 pubmed
    ..Whether the toxin (which is similar in structure to the antibiotic valinomycin) plays a competitive role in the environment therefore remains unclear. ..
  16. Ehling Schulz M, Svensson B, Guinebretiere M, Lindbäck T, Andersson M, Schulz A, et al. Emetic toxin formation of Bacillus cereus is restricted to a single evolutionary lineage of closely related strains. Microbiology. 2005;151:183-97 pubmed
    ..It may have originated only recently through acquisition of specific virulence factors such as the cereulide synthetase gene. ..
  17. Biesta Peters E, Reij M, Blaauw R, In t Veld P, Rajkovic A, Ehling Schulz M, et al. Quantification of the emetic toxin cereulide in food products by liquid chromatography-mass spectrometry using synthetic cereulide as a standard. Appl Environ Microbiol. 2010;76:7466-72 pubmed publisher
  18. Encarnacion H, Parra J, Mears E, Sadler V. Vomiting. Compend Contin Educ Vet. 2009;31:E8 pubmed
    ..This article reviews the anatomic and physiologic aspects of the vomiting reflex and its neurotransmitters, associated receptors, and rational management. ..
  19. Osborne R, Grove A, Oh P, Mabry T, Ng J, Seawright A. The magical and medicinal usage of Stangeria eriopus in South Africa. J Ethnopharmacol. 1994;43:67-72 pubmed
    ..17% and 0.21% in fresh and dry caudex material, respectively and appears to be accompanied by the related toxin, macrozamin...
  20. Wu W, Zhou H, Bursian S, Link J, Pestka J. Emetic responses to T-2 toxin, HT-2 toxin and emetine correspond to plasma elevations of peptide YY3-36 and 5-hydroxytryptamine. Arch Toxicol. 2016;90:997-1007 pubmed publisher
    ..Taken together, the results suggest that T-2 and HT-2 were much more potent than emetine and that emesis induction by all three translational inhibitors co-occurred with increases in circulating levels of PYY3-36 and 5-HT. ..
  21. Juurlink D, McGuigan M. Gastrointestinal decontamination for enteric-coated aspirin overdose: what to do depends on who you ask. J Toxicol Clin Toxicol. 2000;38:465-70 pubmed
    ..Considerable variability exists in the recommendations of North American poison control centers for the gastrointestinal decontamination of patients with large, acute overdoses of enteric-coated aspirin. ..
  22. Hirokawa Y, Harada H, Yoshikawa T, Yoshida N, Kato S. Synthesis and structure-activity relationships of 4-amino-5-chloro-N-(1,4-dialkylhexahydro-1,4-diazepin-6-yl)-2-methoxybenzamide derivatives, novel and potent serotonin 5-HT3 and dopamine D2 receptors dual antagonist. Chem Pharm Bull (Tokyo). 2002;50:941-59 pubmed
  23. Darmani N, Johnson J. Central and peripheral mechanisms contribute to the antiemetic actions of delta-9-tetrahydrocannabinol against 5-hydroxytryptophan-induced emesis. Eur J Pharmacol. 2004;488:201-12 pubmed
  24. Marc B. Managing high-risk body-stuffers who swallow the evidence. J Forensic Leg Med. 2008;15:200-1 pubmed publisher
  25. Nakayama H, Nakayama T, Carnes C, Strauch S, Hamlin R. Electrophysiologic and hemodynamic effects of apomorphine in dogs. Toxicol Appl Pharmacol. 2001;177:157-61 pubmed
    ..5 mg/kg, cardiovascular changes were minimal. The emetic dose is higher than that for Parkinson's disease or erectile dysfunction; thus apomorphine appears to be a safe compound for clinical use in dogs and by extrapolation to man. ..
  26. Krenzelok E. New developments in the therapy of intoxications. Toxicol Lett. 2002;127:299-305 pubmed
  27. Ressel G. AAP releases policy statement on poison treatment in the home. Am Fam Physician. 2004;69:741-2 pubmed
  28. Casavant M, Fitch J. Fatal hypernatremia from saltwater used as an emetic. J Toxicol Clin Toxicol. 2003;41:861-3 pubmed
    ..He suffered numerous complications and died from cerebral herniation. This case is presented to remind physicians of the dangers of this obsolete therapy. ..
  29. Garrison J, Shepherd G, Huddleston W, Watson W. Evaluation of the time frame for home ipecac syrup use when not kept in the home. J Toxicol Clin Toxicol. 2003;41:217-21 pubmed
    ..Ipecac syrup often could not be administered in a timely manner because it was not kept in the home. Parents of pediatric patients who have a significant ingestion should not be referred to purchase ipecac syrup. ..
  30. Beleslin D, Strbac M, Jovanovic Micic D, Samardzic R, Nedelkovski V. Area postrema: cholinergic and noradrenergic regulation of emesis. A new concept. Arch Int Physiol Biochim. 1989;97:107-15 pubmed
    ..Finally, cholinergic terminals sometimes bypass this area and synapse in the emetic regions of the brainstem regulating emesis. ..
  31. Kim J, Kim J, Kim C, Seo K, Park Y, Choi N, et al. Emetic toxin producing Bacillus cereus Korean isolates contain genes encoding diarrheal-related enterotoxins. Int J Food Microbiol. 2010;144:182-6 pubmed publisher
    ..Thus, emetic toxin and enterotoxin genes should be constantly screened to provide insight into B. cereus food poisoning. ..
  32. Asano T, Sadakane C, Ishihara K, Yanagisawa T, Kimura M, Kamei H. High-performance liquid chromatographic assay with fluorescence detection for the determination of cephaeline and emetine in human plasma and urine. J Chromatogr B Biomed Sci Appl. 2001;757:197-206 pubmed
    ..5 ng/ml, respectively, in plasma, and 5 ng/ml in urine. Intra- and inter-day relative standard deviations were below 15%. The assay is sensitive, specific and applicable to pharmacokinetic studies in humans. ..
  33. Sakaguchi J, Iwsaki N, Iwanaga Y, Saito T, Takahara E, Kato H, et al. Synthesis and gastrointestinal prokinetic activity of novel benzamide derivatives with amphoteric side chains. Chem Pharm Bull (Tokyo). 2001;49:424-36 pubmed
  34. Maina E, Hu D, Asano K, Nakane A. Inhibition of emetic and superantigenic activities of staphylococcal enterotoxin A by synthetic peptides. Peptides. 2012;38:1-7 pubmed publisher
    ..These regions could be important targets for therapeutic intervention against SEA exposure. ..
  35. Fountain J, Beasley D. Activated charcoal supercedes ipecac as gastric decontaminant. N Z Med J. 1998;111:402-4 pubmed
    ..This article outlines the relative merits of syrup of ipecacuanha and activated charcoal, and concludes that the latter is preferable in many respects. Details of its appropriate administration are discussed. ..
  36. Steffen K, Mitchell J, Roerig J, Lancaster K. The eating disorders medicine cabinet revisited: a clinician's guide to ipecac and laxatives. Int J Eat Disord. 2007;40:360-8 pubmed
    ..Patients with BN should be screened for use of both ipecac and laxatives and should be educated about the potential consequences associated with the misuse of these agents. ..
  37. Biesta Peters E, Dissel S, Reij M, Zwietering M, In t Veld P. Characterization and Exposure Assessment of Emetic Bacillus cereus and Cereulide Production in Food Products on the Dutch Market. J Food Prot. 2016;79:230-8 pubmed publisher
    ..The main food safety focus associated with this pathogen should be to prevent germination and growth of any B. cereus present in food products and thus prevent cereulide production in foods. ..
  38. Fukui H, Miwa E, Iwachido T, Kitaura H, Furukawa H. Various emetogens increase the secretion of salivary amylase in rats: a potential model in emesis research. J Pharmacol Sci. 2010;113:143-52 pubmed
    ..These results suggest that salivary amylase activity is useful as a marker for emesis in rats, a species that does not exhibit vomiting. ..
  39. Wilson G. Chemical aversion conditioning in the treatment of alcoholism: further comments. Behav Res Ther. 1991;29:415-9; discussion 421-8 pubmed
    ..The onus is on proponents of this method to demonstrate its specific advantages over alternative treatments. ..
  40. Beuhler M, Sasser H, Watson W. The outcome of North American pediatric unintentional mushroom ingestions with various decontamination treatments: an analysis of 14 years of TESS data. Toxicon. 2009;53:437-43 pubmed publisher
    ..If decontamination therapy is being performed, and this data suggests it may not be necessary, syrup of ipecac could still be considered an effective option. ..
  41. van Hecke O, Norfolk G. Püschel K, Bachmann D. Proving possession of drugs in so-called body-stuffers. J Forensic Legal Med 2007;14:96-8. J Forensic Leg Med. 2008;15:127-8 pubmed publisher
  42. Criddle L. An overview of pediatric poisonings. AACN Adv Crit Care. 2007;18:109-18 pubmed
  43. Kan K, Jones R, Ngan M, Rudd J, Wai M. Emetic action of the prostanoid TP receptor agonist, U46619, in Suncus murinus (house musk shrew). Eur J Pharmacol. 2003;482:297-304 pubmed
    ..The action of CP-122,721 to reduce U46619-induced emesis extends the spectrum of anti-emetic action tachykinin NK(1) receptor antagonists to mechanisms involving TP receptors. ..
  44. Billah M, Cooper N, Minnicozzi M, Warneck J, Wang P, Hey J, et al. Pharmacology of N-(3,5-dichloro-1-oxido-4-pyridinyl)-8-methoxy-2-(trifluoromethyl)-5-quinoline carboxamide (SCH 351591), a novel, orally active phosphodiesterase 4 inhibitor. J Pharmacol Exp Ther. 2002;302:127-37 pubmed
    ..Thus, SCH 351591 exhibits a promising preclinical profile as a treatment for asthma and COPD. ..
  45. Shishido Y, Ito F, Morita H, Ikunaka M. Stereoselective synthesis of a novel 2-aza-7-oxabicyclo[3.3.0]octane as neurokinin-1 receptor antagonist. Bioorg Med Chem Lett. 2007;17:6887-90 pubmed
    ..22 nM. This new structural scaffold demonstrated significant in vivo antagonistic activity in the guinea pig ureter capsaicin-induced plasma extravasation model with an ED(50) value of 1-10mg/kg, po. ..
  46. Kim J, Park J, Kim M, Hong S, Park J, Oh D. Genetic diversity of emetic toxin producing Bacillus cereus Korean strains. Int J Food Microbiol. 2011;150:66-72 pubmed publisher
    ..cereus. JNHE 7 and JNHE 53 formed composite cluster 3 and 4. Emetic B. cereus Korean strains showed genotypic diversity comparing with the previous studies. ..
  47. Robery S, Mukanowa J, Percie du Sert N, Andrews P, Williams R. Investigating the effect of emetic compounds on chemotaxis in Dictyostelium identifies a non-sentient model for bitter and hot tastant research. PLoS ONE. 2011;6:e24439 pubmed publisher
    ..These results therefore demonstrate that Dictyostelium has potential as a non-sentient model in the analysis of the molecular effects of tastants, although it has limited utility in identification of emetic agents in general. ..
  48. Barry J. Diagnosis and management of the poisoned child. Pediatr Ann. 2005;34:937-46 pubmed
    ..Prevention efforts have the potential to decrease the incidence of pediatric poisonings. The universal poison control center number provided should be distributed and posted in homes, clinics, and emergency departments. ..
  49. Hojer J, Troutman W, Hoppu K, Erdman A, Benson B, Megarbane B, et al. Position paper update: ipecac syrup for gastrointestinal decontamination. Clin Toxicol (Phila). 2013;51:134-9 pubmed publisher
    ..There are, however, insufficient data to support or exclude ipecac administration soon after ingestion of some specific poisons in rare situations. ..
  50. Makarasen A, Yoza K, Isobe M. Higher structure of cereulide, an emetic toxin from Bacillus cereus, and special comparison with valinomycin, an antibiotic from Streptomyces fulvissimus. Chem Asian J. 2009;4:688-98 pubmed publisher
  51. Ueda S, Kuwabara Y. Rapid identification of emetic Bacillus cereus by immunochromatography. Biocontrol Sci. 2011;16:41-5 pubmed
    ..cereus. The present assay could identify easily and specifically the emetic type of B. cereus within 30 min by a pure culture without special techniques and instruments. ..
  52. Verster R, Botha C, Naidoo V, Van Schalkwyk O. Aldicarb poisoning of dogs and cats in Gauteng during 2003. J S Afr Vet Assoc. 2004;75:177-81 pubmed
    ..Other questions included duration of treatment, survival rate, cost to clients, post mortem findings and reasons for poisonings. ..
  53. Yamashita M, Yamashita M, Azuma J. Urinary excretion of ipecac alkaloids in human volunteers. Vet Hum Toxicol. 2002;44:257-9 pubmed
    ..These results show that ipecac alkaloids may be detectable in urine several weeks after ingestion and suggest that their detection in urine may be helpful to identify the Munchausen syndrome by proxy using ipecac syrup. ..