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Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse

Loperamide is an antidiarrheal agent available as an inexpensive over-the-counter (OTC) medication. In general, it is considered to be safe, but lately, loperamide drug abuse has been reported due to its opioid properties. When used in high doses, several harmful effects including cardiotoxicity, ce...

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Autores principales: Palkar, Pooja, Kothari, Dipti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039153/
https://www.ncbi.nlm.nih.gov/pubmed/30013863
http://dx.doi.org/10.7759/cureus.2599
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author Palkar, Pooja
Kothari, Dipti
author_facet Palkar, Pooja
Kothari, Dipti
author_sort Palkar, Pooja
collection PubMed
description Loperamide is an antidiarrheal agent available as an inexpensive over-the-counter (OTC) medication. In general, it is considered to be safe, but lately, loperamide drug abuse has been reported due to its opioid properties. When used in high doses, several harmful effects including cardiotoxicity, central nervous system (CNS) and respiratory depression have been reported. This prompted the FDA to release a warning in 2016 regarding the arrhythmogenic potential of loperamide. We present a case of a 32-year-old male with a history of polysubstance abuse who presented to the emergency department (ED) requesting “detoxification” from loperamide. The patient complained of opiate withdrawal symptoms including chills, nausea, vomiting, constipation, and abdominal cramps thought to be secondary to the abuse of loperamide. He was found to have right bundle branch block (RBBB) and bradycardia with a heart rate (HR) of 51 beats per min (bpm). He also reported an unexplained syncopal episode, one day prior to visiting the ED. In the current case report, we discuss loperamide abuse, its harmful effects, and management.
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spelling pubmed-60391532018-07-16 Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse Palkar, Pooja Kothari, Dipti Cureus Emergency Medicine Loperamide is an antidiarrheal agent available as an inexpensive over-the-counter (OTC) medication. In general, it is considered to be safe, but lately, loperamide drug abuse has been reported due to its opioid properties. When used in high doses, several harmful effects including cardiotoxicity, central nervous system (CNS) and respiratory depression have been reported. This prompted the FDA to release a warning in 2016 regarding the arrhythmogenic potential of loperamide. We present a case of a 32-year-old male with a history of polysubstance abuse who presented to the emergency department (ED) requesting “detoxification” from loperamide. The patient complained of opiate withdrawal symptoms including chills, nausea, vomiting, constipation, and abdominal cramps thought to be secondary to the abuse of loperamide. He was found to have right bundle branch block (RBBB) and bradycardia with a heart rate (HR) of 51 beats per min (bpm). He also reported an unexplained syncopal episode, one day prior to visiting the ED. In the current case report, we discuss loperamide abuse, its harmful effects, and management. Cureus 2018-05-09 /pmc/articles/PMC6039153/ /pubmed/30013863 http://dx.doi.org/10.7759/cureus.2599 Text en Copyright © 2018, Palkar et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Palkar, Pooja
Kothari, Dipti
Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title_full Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title_fullStr Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title_full_unstemmed Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title_short Bradycardia and Syncope in a Patient Presenting With Loperamide Abuse
title_sort bradycardia and syncope in a patient presenting with loperamide abuse
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039153/
https://www.ncbi.nlm.nih.gov/pubmed/30013863
http://dx.doi.org/10.7759/cureus.2599
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