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July 19, 1947

Current Comment

JAMA. 1947;134(12):1020. doi:10.1001/jama.1947.02880290034014

TOXIC ACTION OF EMETINE HYDROCHLORIDE ON THE HEART  Recently Dack and Moloshok1 reported 9 cases of amebic dysentery in which toxic cardiac manifestations developed following treatment with emetine hydrochloride. The total doses of emetine varied from 7 to 22 grains (0.45 to 1.42 Gm.). The principal signs of toxic effects on the heart were dyspnea and tachycardia on mild exertion, fatigue and electrocardiographic changes generally involving the T waves. Because of the variation in the dosage of emetine hydrochloride which produced toxic cardiac effects, the investigators believe that there are individual differences in susceptibility to the drug or in the rate of its excretion. Signs of toxic effects were generally apparent in the neuromuscular and gastrointestinal systems before evidence of harm to the heart was manifest. These investigators believe that maintaining the patient at absolute bed rest throughout