Left Ventricular Regional Wall Motion Abnormality in the Setting of Acute Loperamide Overdose.


Journal

Clinical practice and cases in emergency medicine
ISSN: 2474-252X
Titre abrégé: Clin Pract Cases Emerg Med
Pays: United States
ID NLM: 101718968

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 23 01 2019
revised: 08 04 2019
accepted: 22 04 2019
entrez: 13 8 2019
pubmed: 14 8 2019
medline: 14 8 2019
Statut: epublish

Résumé

Loperamide is an inexpensive, over-the-counter antidiarrheal agent with emerging reports of overdose due to its opioid properties. Although it is considered by many patients to be safe, cardiotoxicity has been reported, prompting the United States Food and Drug Administration to release a warning regarding the arrhythmogenic potential of loperamide. We present a case of a 32-year-old male presenting in acute loperamide overdose and subsequent cardiac dysrhythmia with focal wall motion abnormalities on echocardiogram. This finding has not been previously reported in the literature and is unique in this clinical presentation. We also highlight the potential mechanisms for loperamide cardiotoxicity and its challenging management.

Identifiants

pubmed: 31403100
doi: 10.5811/cpcem.2019.4.42510
pii: cpcem-3-262
pmc: PMC6682251
doi:

Types de publication

Case Reports

Langues

eng

Pagination

262-266

Déclaration de conflit d'intérêts

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Références

Rev Gastroenterol Disord. 2007;7 Suppl 3:S11-8
pubmed: 18192961
Br J Pharmacol. 2011 Sep;164(2):260-73
pubmed: 21480866
Drug Alcohol Depend. 2013 Jun 1;130(1-3):241-4
pubmed: 23201175
Pharmacotherapy. 2015 Feb;35(2):234-8
pubmed: 25645123
Br J Clin Pharmacol. 2016 Mar;81(3):482-7
pubmed: 26409027
J Emerg Med. 2016 Mar;50(3):508-9
pubmed: 26794455
Naunyn Schmiedebergs Arch Pharmacol. 2016 Oct;389(10):1133-7
pubmed: 27530870
Case Rep Cardiol. 2016;2016:5040176
pubmed: 27547470
Pharmacotherapy. 2017 Feb;37(2):249-253
pubmed: 27995643
Clin Toxicol (Phila). 2017 Aug;55(7):659-661
pubmed: 28349724
Am J Ther. 2018 Sep/Oct;25(5):e548-e550
pubmed: 28639963
J Community Hosp Intern Med Perspect. 2017 Sep 19;7(4):222-226
pubmed: 29046747
Br Med J (Clin Res Ed). 1987 May 30;294(6584):1383
pubmed: 3109665
Lancet. 1980 Jun 28;1(8183):1413
pubmed: 6104193
Clin Pharmacol Ther. 1980 May;27(5):659-64
pubmed: 7371363
Clin Pharmacol Ther. 1980 Dec;28(6):812-9
pubmed: 7438696

Auteurs

Kasha Bornstein (K)

University of Miami Miller School of Medicine, Miami, Florida.

Timothy Montrief (T)

Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida.

Mehruba Anwar Parris (MA)

Jackson Memorial Hospital, Department of Emergency Medicine, Miami, Florida.

Classifications MeSH