Bhandari Binita, Siddique Saima, Tahir Sahar, Link Michael G
Hospital Medicine, University of Pittsburgh Medical Center (UPMC) Harrisburg, Harrisburg, USA.
Cardiology, University of Pittsburgh Medical Center (UPMC) Harrisburg, Harrisburg, USA.
Cureus. 2024 Jul 12;16(7):e64427. doi: 10.7759/cureus.64427. eCollection 2024 Jul.
Loperamide is a readily available, over-the-counter medication used to treat diarrhea. At therapeutic doses, loperamide exerts its effects mainly on the intestinal opioid receptors with minimal psychoactive effects; however, at supratherapeutic doses, it reaches central opioid receptors. With tighter regulations on opioid prescriptions, loperamide has emerged as a popular drug of abuse among opioid users. At supratherapeutic doses, loperamide can cause severe cardiac toxicity, resulting in wide QRS rhythms, severe bradycardia, prolonged QTc, polymorphic ventricular tachycardia, and cardiac arrest. We present the case of a 27-year-old female with a history of heroin abuse who suffered torsades de pointes resulting in cardiac arrest in the setting of a loperamide overdose.
洛哌丁胺是一种易于获得的非处方药物，用于治疗腹泻。在治疗剂量下，洛哌丁胺主要作用于肠道阿片受体，精神活性作用极小；然而，在超治疗剂量下，它会作用于中枢阿片受体。随着对阿片类药物处方的监管更加严格，洛哌丁胺已成为阿片类药物使用者中一种流行的滥用药物。在超治疗剂量下，洛哌丁胺可导致严重的心脏毒性，导致宽QRS波心律、严重心动过缓、QTc延长、多形性室性心动过速和心脏骤停。我们报告一例27岁有海洛因滥用史的女性，在洛哌丁胺过量的情况下发生尖端扭转型室速导致心脏骤停。
