Loperamide-Induced Torsades de Pointes.
arrythmia
cardiac arrythmia
loperamide
loperamide toxicity
medical toxicology
torsades de pointes
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
accepted:
08
12
2021
entrez:
14
1
2022
pubmed:
15
1
2022
medline:
15
1
2022
Statut:
epublish
Résumé
Loperamide, an over-the-counter antidiarrheal, works on the µ opioid receptor with minimal opioid activity if taken as directed. Recently, it has gained popularity as the "poor man's methadone" at supratherapeutic dosing. Opioid antagonism with naloxone is beneficial in reversing respiratory depression but has no effect on cardiotoxicity due to the human ether-a-go-go-related gene (hERG). We present the case of a 34-year-old female who presented for syncope after taking 48 tablets of 2 mg loperamide. On arrival, she was obtunded with variable heart block and a QTc of 560 ms. Subsequently, due to further QT prolongation from loperamide to 656 ms, she developed Torsades de Pointes requiring defibrillation at 120 J twice. Ultimately, she was discharged home with psychiatric and substance abuse outpatient follow-up. Patients and healthcare providers face new challenges with the increase in loperamide misuse due to easy access and delayed identification. It is important for clinicians to recognize and be familiar with loperamide overdose given the potential for multiorgan failure and increased mortality.
Identifiants
pubmed: 35028205
doi: 10.7759/cureus.20299
pmc: PMC8747988
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e20299Informations de copyright
Copyright © 2021, Isang et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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