Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone”
Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperam...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Greater Baltimore Medical Center
2017-10-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20009666.2017.1351290 |
| _version_ | 1797967457635270656 |
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| author | Amr Salama Yana Levin Pramod Jha Richard Alweis |
| author_facet | Amr Salama Yana Levin Pramod Jha Richard Alweis |
| author_sort | Amr Salama |
| collection | DOAJ |
| description | Loperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out. Loperamide induces QTc prolongation and cardiac dysrhythmias. She had recurrent ventricular arrhythmias with multiple cardiac arrests. The persistence of the cardiotoxicity for a longer duration than previously reported in the literature is unique in this clinical presentation. We also highlight the potential mechanisms for loperamide cardiotoxicity and its challenging management. Abbreviations: ACLS: Advanced cardiac life support; GI: Gastrointestinal |
| first_indexed | 2024-04-11T02:30:25Z |
| format | Article |
| id | doaj.art-9b1c797a280f40d3b4643b139861a056 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:30:25Z |
| publishDate | 2017-10-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-9b1c797a280f40d3b4643b139861a0562023-01-02T21:29:57ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662017-10-017422222610.1080/20009666.2017.13512901351290Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone”Amr Salama0Yana Levin1Pramod Jha2Richard Alweis3Unity HospitalUnity HospitalUnity HospitalUnity HospitalLoperamide is an over-the-counter antidiarrheal agent that is considered by many patients to be safe, but has been used as a drug of abuse due to its opioid properties. However, cardiotoxicity has been reported, prompting the FDA to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 38-year-old female presenting with cardiac arrest thought to be secondary to abuse of the loperamide that she was using to alleviate the heroin withdrawal symptoms. Cardiac ischemia and other drug toxicities were ruled out. Loperamide induces QTc prolongation and cardiac dysrhythmias. She had recurrent ventricular arrhythmias with multiple cardiac arrests. The persistence of the cardiotoxicity for a longer duration than previously reported in the literature is unique in this clinical presentation. We also highlight the potential mechanisms for loperamide cardiotoxicity and its challenging management. Abbreviations: ACLS: Advanced cardiac life support; GI: Gastrointestinalhttp://dx.doi.org/10.1080/20009666.2017.1351290Loperamide overdoseventricular fibrillationQTc prolongationbradycardia-induced tachyarrhythmiaTorsade de Pointes |
| spellingShingle | Amr Salama Yana Levin Pramod Jha Richard Alweis Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” Journal of Community Hospital Internal Medicine Perspectives Loperamide overdose ventricular fibrillation QTc prolongation bradycardia-induced tachyarrhythmia Torsade de Pointes |
| title | Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
| title_full | Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
| title_fullStr | Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
| title_full_unstemmed | Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
| title_short | Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
| title_sort | ventricular fibrillation due to overdose of loperamide the poor man s methadone |
| topic | Loperamide overdose ventricular fibrillation QTc prolongation bradycardia-induced tachyarrhythmia Torsade de Pointes |
| url | http://dx.doi.org/10.1080/20009666.2017.1351290 |
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