Sun Christie, Brice Jessica A, Clark Richard F
Division of Medical Toxicology, University of California San Diego, San Diego, California; Department of Emergency Medicine, University of California San Diego, San Diego, California.
Department of Emergency Medicine, University of California San Diego, San Diego, California.
J Emerg Med. 2018 Apr;54(4):484-486. doi: 10.1016/j.jemermed.2017.12.040. Epub 2018 Feb 10.
Loperamide has been increasing in popularity recently for its effects separate from treatment of diarrhea. In large doses or in combination with other agents, it can lead to desirable effects in the central nervous system. However, cardiotoxicity has been reported with its abuse.
A 49-year-old male who had been chronically abusing loperamide was found to have Brugada-like changes on his electrocardiogram (ECG). He had no other clinical symptoms associated with Brugada syndrome and did not have similar findings on previous ECGs. After abstaining from further loperamide use during hospitalization, this pattern slowly resolved without clinically significant dysrthymias. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A patient with a history of loperamide abuse is at risk for cardiotoxicity. While other dysrhythmias are reported more commonly with loperamide abuse, Brugada-like ECG changes can occur and warrant appropriate consultation and prompt follow-up.
洛哌丁胺近来因其在治疗腹泻之外的作用而日益受到欢迎。大剂量使用或与其他药物联合使用时，它可在中枢神经系统产生理想效果。然而，已有其滥用导致心脏毒性的报道。
一名长期滥用洛哌丁胺的49岁男性被发现心电图（ECG）有类似Brugada综合征的改变。他没有与Brugada综合征相关的其他临床症状，之前的心电图也没有类似表现。住院期间停止进一步使用洛哌丁胺后，这种心电图模式逐渐消失，未出现具有临床意义的心律失常。急诊医生为何应了解这一点？：有洛哌丁胺滥用史的患者有心脏毒性风险。虽然洛哌丁胺滥用更常报告其他心律失常，但也可出现类似Brugada综合征的心电图改变，需要进行适当会诊并及时随访。
