Epic Ape is a 6-reel slot with 4 rows and 4096 ways to win. This means that there is no payline layout and all it takes for you to perform winning combos are land symbols on the adjacent reels starting from the left side. The vines hang from these reels that float against a densely wooded bottom. The most valuable symbols are all the animals in. Download and use 500+ ape stock photos for free. Daily thousands of new images Completely Free to Use High-quality videos and images from Pexels.

Episcope Medical

Head to a dense jungle

Visually, Epic Ape is set in a dense jungle – symbols on the reels include regular playing cards (A, K, Q, J, 10 and 9) as well as chameleons, frogs, panthers and jaguars. The most rewarding symbol is the ape of course which gives you 12 times your stake for a 6 of a kind combination across a payline. The ape also appears stacked on all reels which helps.

Free Games feature

The diamond is the wild symbol and substitutes for all other symbols bar the Free Games scatter – it also only appears on reels 2, 3, 4, 5 and 6 (i.e. not reel 1). The wild becomes especially important during the Free Games feature which is accessed when you get 3 or more Free Games scatter symbols anywhere on the reels. The amount of free spins you get depends on how many scatters you get to trigger the feature:

3 scatters give you 8 free spins
4 scatters give you 15 free spins
5 scatters give you 25 free spins
6 scatters give you 100 free spins

Multipliers up to 5x with unlimited retriggers

Back to the diamond wild – during the feature, you will benefit from a random multiplier of 2x, 3x or 5x when the wild is part of a winning combination. Furthermore, 2 or more scatters landing simultaneously during a free spin will give you more free spins as 2, 3, 4, 5 or 6 scatters will reward you with an extra 5, 8, 15, 25 or 100 free spins. You can retrigger free spins infinitely too!

High variance Epic Ape

Epic Ape is quite a simple slot but is highly volatile – it reminds me a lot of WMS’ Raging Rhino as it has a similar theme, the same number of reels and paylines and diamond wilds with multipliers! Overall, a superb offering from Playtech and a superb and similar alternative to the WMS favourite.

Syrup of ipecac
Clinical data
Routes of administration	Oral
ATC code
Legal status
Legal status	OTC^[where?]
Identifiers
CAS Number
ChemSpider	none
UNII
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Syrup of ipecac (/ˈɪpɪkæk/), commonly referred to as ipecac, is a drug that was once widely used as an expectorant (in low doses) and a rapid-acting emetic (in higher doses). It is obtained from the dried rhizome and roots of Carapichea ipecacuanha from which it derives its name.

In particular, the rapidly induced forceful vomiting produced by ipecac was considered for many years to be an important front-line treatment for orally ingested poisons. However, subsequent studies (including a comprehensive 2005 meta-study) revealed the stomach purging produced by ipecac to be far less effective at lowering total body poison concentrations than the adsorption effect of oral activated charcoal (which is effective through the entire gastrointestinal tract and is often coupled with whole bowel irrigation). Ipecac also presents a small risk of overdose (being a mild poison itself) and a major risk of esophagitis and aspiration pneumonia if used to purge corrosive poisons. Having long been replaced (even in the emetic role) by more effective medications, the American Society of Health-System Pharmacists now advises that 'Ipecac syrup is no longer recommended for routine management of outpatient ingestions of medications or other chemicals.'^[1]

Preparation[edit]

The commercial preparation of ipecac consists of 1/14 of an alcoholic extract of the roots and rhizomes of Carapichea ipecacuanha. The rest is composed of glycerin, sugar syrup, and methylparaben. Ipecac root itself is a poison, but in this diluted form, its ability to induce immediate vomiting means that the syrup is seldom fatal.^[2]^{[citation needed]}

Use[edit]

Ipecac was used in cough mixtures as an expectorant or an emetic from the 18th until the early 20th century.^{[citation needed]} For instance, Ipecac and opium were used to produce Dover's powder, which was used in syrup form.^{[citation needed]}

In 1965, the FDA approved the sale of up to one ounce of syrup of ipecac without a prescription. At the time it was approved, its use was recommended by the AAP, AAPCC, AMA, and the FDA's medical advisory board as a method to induce vomiting 'for quick first-aid use in the home, under medical supervision', for use in cases of accidental poisoning.^[2]^[3]

Current guidelines from the American Academy of Pediatrics, however, strongly advise against this and in fact recommend the disposal of any syrup of ipecac present in the home.^[4] Many toxicological associations have also issued position papers recommending against its use as a first-line treatment for most ingested poisons,^[5] because of a lack of evidence that syrup of ipecac actually helps improve the outcome in cases of poisoning. Moreover, accidental overdose of ipecac can result when administered in the home.^[6] When dealing with poisoning cases in the hospital, it became difficult to obtain a differential diagnosis when syrup of ipecac had been administered, as this can add further symptoms.

A 2005 review by an HRSA-funded scientific panel concluded that vomiting alone does not reliably remove poisons from the stomach. The study suggested that indications for use of ipecac syrup were rare, and patients should be treated by more effective and safer means. Additionally, its potential side effects, such as lethargy, can be confused with the poison's effects, complicating diagnosis. The use of ipecac may also delay the use of other treatments (e.g., activated charcoal, whole bowel irrigation, or oral antidotes) or make them less effective.^[7]

Misuse[edit]

Ipecac has been used by individuals with bulimia nervosa as a means to achieve weight loss through induced vomiting. Repeated use in this manner is believed to cause damage to the heart and muscles, which can ultimately result in the user's death.^[8] Misuse of ipecac has been blamed for the death of singer Karen Carpenter in 1983.^[9] It has also been used as an agent for Münchausen syndrome by proxy.^[10]

Mechanism of action[edit]

The actions of ipecac are mainly those of major alkaloids, emetine (methylcephaeline) and cephaeline.^{[citation needed]} They both act locally by irritating the gastric mucosa and centrally by stimulating the medullary chemoreceptor trigger zone to induce vomiting.^{[citation needed]}

Discontinuation[edit]

Ipecac has been found to have minimal health benefits, and is ultimately ineffective at purging the body of poisonous substances. It was initially discontinued due to production costs and lack of raw materials. As the ASHP advises: 'Ipecac syrup is no longer recommended for routine management of outpatient ingestions of medications or other chemicals.' Humco and Paddock Laboratories, the only two remaining manufacturers, both stopped production of ipecac syrup in 2010.^[11]

A heavily cited position statement outlines critical details of its effectiveness:

In experimental studies the amount of marker removed by ipecac was highly variable and diminished with time. There is no evidence from clinical studies that ipe

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