Wang Bowen, Zhang Zhan, Chen Ke, Du Zhongyang, Zhang Tianchen, Xie Ping
Department of Cardiovascular Medicine, Gansu Provincial Hospital, Lanzhou, China.
First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China.
Front Pharmacol. 2025 Aug 22;16:1597869. doi: 10.3389/fphar.2025.1597869. eCollection 2025.
Loperamide is a medication commonly used to treat acute and chronic diarrhea and is generally considered safe because it poorly crosses the blood-brain barrier at therapeutic doses. However, in recent years, with the abuse and overdose of loperamide, its potential cardiotoxicity and central nervous system depression have increasingly raised concerns. This article reports a case of a 15-year-old male patient who died from poisoning after a single ingestion of 60 mg of loperamide. The patient took a large dose of loperamide 6 h before admission and was found to have respiratory and cardiac arrest 1 h before admission. Despite cardiopulmonary resuscitation and advanced life support treatment, the patient ultimately died from irreversible brain damage. Electrocardiography showed significant QTc interval prolongation, and the plasma loperamide concentration was 50 ng/mL, indicating loperamide's cardiotoxicity. This article, through this case and a review of the literature, discusses the mechanisms of loperamide's cardiotoxicity, clinical manifestations, and treatment strategies, aiming to enhance clinicians' awareness of loperamide poisoning.
洛哌丁胺是一种常用于治疗急慢性腹泻的药物，由于其在治疗剂量下难以穿过血脑屏障，通常被认为是安全的。然而，近年来，随着洛哌丁胺的滥用和过量使用，其潜在的心脏毒性和中枢神经系统抑制作用越来越引起人们的关注。本文报告了一例15岁男性患者，单次摄入60毫克洛哌丁胺后中毒死亡。患者在入院前6小时服用了大量洛哌丁胺，入院前1小时被发现呼吸和心脏骤停。尽管进行了心肺复苏和高级生命支持治疗，患者最终因不可逆转的脑损伤死亡。心电图显示QTc间期显著延长，血浆洛哌丁胺浓度为50纳克/毫升，表明洛哌丁胺具有心脏毒性。本文通过该病例及文献复习，探讨了洛哌丁胺心脏毒性的机制、临床表现及治疗策略，旨在提高临床医生对洛哌丁胺中毒的认识。
