medigraphic.com
SPANISH

Medicina Interna de México

Colegio de Medicina Interna de México.
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2020, Number 1

<< Back Next >>

Med Int Mex 2020; 36 (1)

Cardiotoxicity due to loperamida

Moranchel-García L, García de Alba-Gaytán A
Full text How to cite this article

Language: Spanish
References: 13
Page: 124-129
PDF size: 212.23 Kb.


Key words:

Loperamide, Bicarbonate, Hemodialysis.

ABSTRACT

Background: Loperamide is an easily available, non-regulated drug used to control gastrointestinal symptoms (diarrhea).
Clinical case: A 79-year-old male patient with intoxication due to loperamide that presented electrocardiographic alterations and hyperkalemia refractory to treatment, which required a pharmacological treatment of cardiotoxicity and renal replacement therapy.
Conclusion: There are few cases reported in relation to adverse effects and toxicity of loperamide and most of them describe neurological and respiratory manifestations (opioid toxin syndrome).


REFERENCES

  1. Wu P, Juurlink D. Clinical review: Loperamide toxicity. Ann Emerg Med August 2017;70(2):245-252. doi: 10.1016/j. annemergmed.2017.04.008.

  2. Sheng J, Tran P, Li Z, et al. Characterization of loperamide- mediated block of hERG channels at physiological temperature and its proarrhythmia propensity. J Pharmacol Toxicol Methods 2017;88:109-122. doi: 10.1016/j. vascn.2017.08.006.

  3. Miller H, Panahi L, Tapia D, et al. Loperamide misuse and abuse. J Am Pharm Assoc 2017;57:S45-S50. doi: 10.1016/j. japh.2016.12.079.

  4. Hurtado G, Sandoval R. An additional clinical scenario of risk for loperamide cardiac-induced toxicity. Am J Med April 2016;129(4):e33. DOI: https://doi.org/10.1016/j. amjmed.2015.10.041.

  5. Palkar P, Kothari D. Bradycardia and syncope in a patient presenting with loperamide abuse. Cureus 2018;10(5):e2599. doi: 10.7759/cureus.2599.

  6. Vitbalani N, Heron C, Rao R, et al. Dysrhythmias with loperamide used for opioid withdrawal. J Am Board Fam Med 2017 Nov-Dec;30(6):832-834. doi: 10.3122/jabfm. 2017.06.170066.

  7. Vakkalanka P, Charlton N, Holstege C. Epidemiologic trends in loperamide abuse and misuse. Ann Emerg Med January 2017;69(1):73-78. doi: 10.1016/j.annemergmed. 2016.08.444.

  8. Idris A, Kaye K. Loperamide abuse cardiotoxicity. Should loperamide still be an over the counter medication? Am J Emerg Med 2018;36(9):1716.e1-1716.e3. doi: 10.1016/j. ajem.2018.05.027.

  9. Lo S, Niu H, Cheng Y, Niu C, Cheng J, Ku P. Loperamideinduced cardiac depression is enhanced by hyperglycemia: evidence relevant to loperamide abuse. Arch Med Res 2017;48:64-72. doi: 10.1016/j.arcmed.2017.01.008.

  10. Upadhyay A, Bodar V, Malekzadegan M, et al., Loperamide induced life threatening ventricular arrhythmia. Case Reports in Cardiology. 2016, Article ID 5040176. http:// dx.doi.org/10.1155/2016/5040176.

  11. Kenneth K, Cannon R, Cook M, et al. Loperamideinduced torsades de pointes: a case series. J Emerg Med 2017;53(3):339-344. doi: 10.1016/j.jemermed.2017.04.027.

  12. Eggleston W, Marraffa J, Stork C, et al. Cardiac dysrhythmias after loperamide abuse - New York, 2008-2016. MMWR 2016 Nov 18;65(45):1276-1277. doi: 10.15585/mmwr. mm6545a7.

  13. Dierksen J, Gonsoulin M, Walterscheid J. Poor man’s methadone a case report of loperamide toxicity. Am J Forensic Med Pathol 2015;36:268-270. doi: 10.1097/ PAF.0000000000000201.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Med Int Mex. 2020;36