title: Unexpected Serious Cardiac Arrhythmias in the Setting of Loperamide Abuse.
abstract: Loperamide (Imodium) is a non-prescription opioid receptor agonist available over-the-counter for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, central nervous system and respiratory depression, and cardiotoxicity. There is an emerging trend in its use among drug abusers for its euphoric effects or for self-treatment of opioid withdrawal. We report a case of ventricular dysrhythmias associated with loperamide abuse in a 28-year-old man who substituted loperamide for the opioids that he used to abuse. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI; The Warren Alpert Medical School of Brown University.
authors.forename: Somwail
authors.initials: S
authors.lastname: Rasla
authors.forename: Parag
authors.initials: P
authors.lastname: Parikh
authors.forename: Peter
authors.lastname: Hoffmeister
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI; College of Pharmacy, University of Rhode Island.
authors.forename: Amy
authors.initials: A
authors.lastname: St Amand
authors.affiliation: Department of Anesthesia and Perioperative Medicine, Tufts Medical Center, Boston, MA; Tufts University School of Medicine.
authors.forename: Marina K
authors.initials: MK
authors.lastname: Garas
authors.affiliation: Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI; The Warren Alpert Medical School of Brown University.
authors.forename: Amr
authors.initials: A
authors.lastname: El Meligy
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI; The Warren Alpert Medical School of Brown University.
authors.forename: Taro
authors.initials: T
authors.lastname: Minami
authors.forename: Nishant R
authors.initials: NR
authors.lastname: Shah
mesh_terms: D000328:Adult; D000930:Antidiarrheals / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000175:diagnosis; D062787:Drug Overdose / Q000150:complications / Q000175:diagnosis*; D004562:Electrocardiography; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008139:Loperamide / Q000506:poisoning*; D008297:Male; D009293:Opioid-Related Disorders; D010353:Patient Education as Topic; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology
chemical_list: D000930:Antidiarrheals; D008139:Loperamide
keywords: Arrhythmias; Lopermide; QTc prolongation; Ventricular tachycardia; opioid abuse