Bhatti Zabeer, Norsworthy Jessica, Szombathy Tamas
a Department of Medicine , State University of New York , Syracuse , NY , USA.
Clin Toxicol (Phila). 2017 Aug;55(7):659-661. doi: 10.1080/15563650.2017.1304555. Epub 2017 Mar 28.
Loperamide is an over-the-counter, peripherally acting, μ-opioid receptor agonist used for the treatment of diarrhea. In recent times users have found that at higher doses, loperamide crosses the blood-brain barrier and reaches central μ-receptors in the brain, leading to central opiate effects including euphoria and respiratory depression. We report a case of a 37-year-old female who attempted suicide with over 200 loperamide tablets. During her overdose, her QTc was significantly prolonged at >600 ms. Our case aims to add to the growing body of literature describing life-threatening ventricular arrhythmias associated with loperamide toxicity and further suggests that a metabolite of loperamide, desmethylloperamide, may play a role in the pathogenesis.
洛哌丁胺是一种非处方的外周作用μ-阿片受体激动剂，用于治疗腹泻。近来，使用者发现，高剂量的洛哌丁胺会穿过血脑屏障，到达大脑中的中枢μ-受体，从而产生包括欣快感和呼吸抑制在内的中枢阿片类效应。我们报告了一例37岁女性试图服用200多片洛哌丁胺自杀的病例。在她过量服药期间，其QTc显著延长，超过600毫秒。我们的病例旨在补充越来越多描述与洛哌丁胺毒性相关的危及生命的室性心律失常的文献，并进一步表明洛哌丁胺的代谢产物去甲基洛哌丁胺可能在发病机制中起作用。
