Loperamide Induced Life Threatening Ventricular Arrhythmia

Area of Science:

• Cardiology
• Clinical Toxicology
• Pharmacology

Background:

• Loperamide, an over-the-counter antidiarrheal, acts on peripheral μ opioid receptors.
• Increasing Loperamide abuse is noted, with individuals using it as an opioid substitute.
• High doses of Loperamide can lead to serious adverse effects.

Purpose of the Study:

• To report a case of cardiac arrest following excessive Loperamide consumption.
• To investigate the potential causal link between Loperamide toxicity and cardiac events.
• To raise awareness regarding the risks of Loperamide abuse.

Main Methods:

• Case report of a 46-year-old male presenting with cardiac arrest.
• Exclusion of other potential causes of cardiac arrest, including ischemia, cardiomyopathy, and sepsis.
• Analysis of patient's Loperamide usage history and cardiac monitoring (QTc interval).

Main Results:

• The patient consumed up to 200 mg of Loperamide daily for two days prior to cardiac arrest.
• Loperamide toxicity was hypothesized as the cause of QTc prolongation and cardiac arrest.
• Gradual resolution of tachyarrhythmia and QTc interval decrease observed during hospitalization.

Conclusions:

• Loperamide overdose can cause QTc prolongation and potentially fatal arrhythmias.
• The case suggests Loperamide may unmask underlying congenital long QT syndrome.
• This case underscores the existence of Loperamide overdose-related cardiac toxicity and the need to address its abuse.