洛哌丁胺致尖端扭转型室性心动过速反复发作：1 例报告。
Loperamide Induced Recurrent Torsades de Pointes: A Case Report.
机构信息
Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
J Pharm Pract. 2022 Oct;35(5):791-795. doi: 10.1177/08971900211004832. Epub 2021 Mar 29.
PURPOSE
A case of loperamide-induced recurrent torsades de pointes is reported to raise awareness of an increasingly common phenomenon that could be encountered by medical providers during the current opioid epidemic.
SUMMARY
A 40 year-old-man with a prior history of opioid abuse who presented to the emergency department after taking up to 100 tablets of loperamide 2 mg daily for 5 years to blunt opioid withdrawal symptoms and was subsequently admitted to the intensive care unit for altered mental status and hyperthermia. The patient had prolonged QTc and 2 episodes of torsades de pointes (TdP) that resulted in cardiac arrest with return of spontaneous circulation. He was managed with isoproterenol, overdrive pacing, and methylnatrexone with no other events of TdP or cardiac arrest.
CONCLUSION
A 40-year-old male who developed torsades de pointes from loperamide overdose effectively treated with overdrive pacing, isoproterenol, and methylnatrexone.
目的
报道 1 例洛哌丁胺引起的复发性尖端扭转型室性心动过速病例，以提高医疗提供者在当前阿片类药物流行期间可能遇到的这种日益常见现象的认识。
摘要
一名 40 岁男性，有阿片类药物滥用史，因 5 年来每日服用多达 100 片 2mg 洛哌丁胺来缓解阿片类药物戒断症状而到急诊就诊，随后因精神状态改变和发热入住重症监护病房。患者出现 QT 间期延长和 2 次尖端扭转型室性心动过速（TdP），导致心搏骤停并恢复自主循环。他接受异丙肾上腺素、超速起搏和甲基纳曲酮治疗，未再发生 TdP 或心搏骤停。
结论
一名 40 岁男性因洛哌丁胺过量导致尖端扭转型室性心动过速，经超速起搏、异丙肾上腺素和甲基纳曲酮治疗有效。
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