一例因滥用洛哌丁胺导致心源性晕厥的病例报告：急性表现及丁丙诺啡的新用途
A Case Report of Cardiogenic Syncope Due to Loperamide Abuse: Acute Presentation and Novel Use of Buprenorphine.
作者信息
Betting David J, Chenoweth James A, Jarman Angela F
机构信息
UC Davis Medical Center, Department of Emergency Medicine, Sacramento, California.
出版信息
Clin Pract Cases Emerg Med. 2021 May;5(2):214-217. doi: 10.5811/cpcem.2021.3.51152.
INTRODUCTION
Loperamide is a non-prescription anti-diarrheal agent targeting μ-opioid receptors in the intestinal tract. At high doses it crosses the blood-brain barrier, where μ-opioid agonism can cause euphoric effects. Misuse has been increasing for both the euphoric effects and as an alternative treatment for opioid dependence and withdrawal.
CASE REPORT
Here we report the case of a 30-year-old woman presenting with syncope, who was found to have severe myocardial conduction delays in the setting of chronic loperamide abuse.
CONCLUSION
Treatment with sodium bicarbonate and hypertonic sodium resulted in improvement of her conduction abnormalities. Prior to discharge she was initiated on buprenorphine for her opioid use disorder.
引言
洛哌丁胺是一种非处方止泻药，作用于肠道中的μ-阿片受体。高剂量时它会穿过血脑屏障，在那里μ-阿片激动作用可产生欣快感。由于欣快感以及作为阿片类药物依赖和戒断的替代治疗方法，其滥用情况一直在增加。
病例报告
在此我们报告一例30岁女性因晕厥就诊的病例，该患者在慢性滥用洛哌丁胺的情况下出现严重心肌传导延迟。
结论
碳酸氢钠和高渗钠治疗改善了她的传导异常。出院前，她开始使用丁丙诺啡治疗阿片类药物使用障碍。
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