Cargando…
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...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637705/ https://www.ncbi.nlm.nih.gov/pubmed/29046747 http://dx.doi.org/10.1080/20009666.2017.1351290 |
_version_ | 1783270642993332224 |
---|---|
author | Salama, Amr Levin, Yana Jha, Pramod Alweis, Richard |
author_facet | Salama, Amr Levin, Yana Jha, Pramod Alweis, Richard |
author_sort | Salama, Amr |
collection | PubMed |
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 |
format | Online Article Text |
id | pubmed-5637705 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-56377052017-10-18 Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” Salama, Amr Levin, Yana Jha, Pramod Alweis, Richard J Community Hosp Intern Med Perspect Case Reports 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 Taylor & Francis 2017-09-19 /pmc/articles/PMC5637705/ /pubmed/29046747 http://dx.doi.org/10.1080/20009666.2017.1351290 Text en © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Reports Salama, Amr Levin, Yana Jha, Pramod Alweis, Richard Ventricular fibrillation due to overdose of loperamide, the “poor man’s methadone” |
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 | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637705/ https://www.ncbi.nlm.nih.gov/pubmed/29046747 http://dx.doi.org/10.1080/20009666.2017.1351290 |
work_keys_str_mv | AT salamaamr ventricularfibrillationduetooverdoseofloperamidethepoormansmethadone AT levinyana ventricularfibrillationduetooverdoseofloperamidethepoormansmethadone AT jhapramod ventricularfibrillationduetooverdoseofloperamidethepoormansmethadone AT alweisrichard ventricularfibrillationduetooverdoseofloperamidethepoormansmethadone |