Larsen Timothy R, McMunn Jedediah, Ahmad Hala, AlMahameed Soufian T
Carilion Clinic, Virginia Tech Carilion School of Medicine, 2001 Crystal Spring Ave, Suite 203, Roanoke, VA, 24014, USA.
Virginia Commonwealth University School of Medicine, PO Box 980509, Richmond, VA, 23298, USA.
Drug Saf Case Rep. 2018 Feb 17;5(1):11. doi: 10.1007/s40800-018-0077-0.
A 32-year-old male developed recurrent ventricular tachycardia after taking mega doses of loperamide and famotidine in order to experience an opiate-like euphoric effect. He was taking up to 200 mg of loperamide and multiple doses of famotidine each day. He developed palpitations and syncope. Electrocardiography demonstrated ventricular tachycardia and QT interval prolongation (corrected QT interval was 597 ms). He was diagnosed with loperamide-induced QT prolongation resulting in incessant ventricular tachycardia. Loperamide was discontinued, and he was treated with electrolyte replacement, supportive care, and monitoring. After 5 days, his electrocardiogram (ECG) normalized and he had no more ventricular tachycardia. A Naranjo assessment score of 8 was obtained, indicating a probable relationship between QT prolongation and his use of loperamide. Large doses of loperamide can cause QT interval prolongation and life-threatening arrhythmias. These effects may be accentuated when histamine-2 receptor blockers are also abused.
一名32岁男性为体验类似阿片类药物的欣快感而服用大剂量洛哌丁胺和法莫替丁后，出现反复发作的室性心动过速。他每天服用多达200毫克洛哌丁胺和多剂法莫替丁。他出现心悸和晕厥。心电图显示室性心动过速和QT间期延长（校正QT间期为597毫秒）。他被诊断为洛哌丁胺引起的QT间期延长导致持续性室性心动过速。停用洛哌丁胺后，他接受了电解质补充、支持治疗和监测。5天后，他的心电图恢复正常，未再出现室性心动过速。Naranjo评估得分为8分，表明QT间期延长与他使用洛哌丁胺之间可能存在关联。大剂量洛哌丁胺可导致QT间期延长和危及生命的心律失常。当同时滥用组胺2受体阻滞剂时，这些效应可能会加剧。
