1 Department of Internal Medicine, Texas Tech University Health Sciences Center, Permian Basin, USA; 2 Department of Critical Care, Texas Tech University Health Sciences Center, Midland Memorial Hospital, Midland, TX, USA; 3 Department of Clinical Pharmacology, Medical Center Hospital, Odessa, TX, USA
Abstract: Abuse of over the counter drugs often gets overlooked by health care providers. Loperamide is one such over the counter drug that is often abused by drug addicts. We present here a case of a young male attaining euphoria from taking massive doses of loperamide. He developed Torsades de Pointes and subsequent cardiac arrest. We found similarities in the progression of myocardial electrical conduction abnormalities among loperamide and other previously known arrhythmogenic drugs. We intend to raise concern over the ease of availability of such drugs over the counter and increase the index of suspicion for over the counter drug abuse from our experience.
Case Reports in Medicine
Volume 2016 (2016), Article ID 4061980, 3 pageshttp://dx.doi.org/10.1155/2016/4061980
Ventricular Dysrhythmias from Loperamide Misuse
Daniel R. Lasoff, MD Veterans’ Administration Medical Center, San Diego, California
Aaron Schneir, MD Department of Emergency Medicine, Division of Medical Toxicology, University of California, San Diego Health System, San Diego, California
Abstract: We would like to alert emergency physicians to the potential for cardiac dysrhythmias associated with the misuse of loperamide. Multiple websites and online forums have described using high doses of oral loperamide for recreational abuse and amelioration of opioid withdrawal (1). A burgeoning number of reports have detailed the potential for QRS width prolongation, QTc prolongation, ventricular dysrhythmias, and cardiac arrest with this practice (2–6). We recently were involved in the management of such a patient.
Journal of Emergency Medicine
March 2016 Volume 50, Issue 3, Pages 508–509