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Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
367
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

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Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.9K
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

331
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
331
Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists01:28

Drugs Affecting GI Tract Motility: Dopamine Receptor Antagonists

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Prokinetic agents are specialized medications that stimulate gastrointestinal (GI) motility, promoting food movement through the GI tract. Dopamine, an inhibitory neurotransmitter, plays a significant role in this process, reducing GI motility and indirectly controlling the speed of digestion. Dopamine receptor antagonists, such as metoclopramide and domperidone, offer a unique advantage as prokinetic agents. By blocking the dopamine receptors, these drugs increase GI motility, improving food...
721
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

402
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Related Experiment Video

Updated: Oct 6, 2025

Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology
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Laser-Induced Action Potential-Like Measurements of Cardiomyocytes on Microelectrode Arrays for Increased Predictivity of Safety Pharmacology

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Loperamide-Induced Torsades de Pointes.

Emmanuel Isang1, Laylan Shali2, Charles B Morris2

  • 1Cardiology, University of Tennessee Medical Center, Knoxville, USA.

Cureus
|January 14, 2022
PubMed
Summary

Loperamide misuse at high doses can cause dangerous heart problems like Torsades de Pointes, even if opioid effects are minimal. Healthcare providers must recognize loperamide overdose risks, including potential multiorgan failure and death.

Keywords:
arrythmiacardiac arrythmialoperamideloperamide toxicitymedical toxicologytorsades de pointes

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Area of Science:

  • Pharmacology
  • Cardiology
  • Toxicology

Background:

  • Loperamide is an over-the-counter antidiarrheal.
  • At therapeutic doses, it acts on µ-opioid receptors with minimal central nervous system effects.
  • It is increasingly misused at supratherapeutic doses, earning the nickname "poor man's methadone."

Observation:

  • A 34-year-old female presented with syncope after ingesting 96 mg of loperamide.
  • Initial presentation included obtundation, variable heart block, and a QTc of 560 ms.
  • QTc interval prolonged to 656 ms, leading to Torsades de Pointes requiring defibrillation.

Findings:

  • Loperamide overdose can cause significant cardiotoxicity, including QT prolongation and Torsades de Pointes.
  • Naloxone, an opioid antagonist, does not reverse loperamide-induced cardiotoxicity.
  • The human ether-a-go-go-related gene (hERG) channel is implicated in loperamide's cardiotoxic effects.

Implications:

  • Increased loperamide misuse presents diagnostic and management challenges for healthcare providers.
  • Early recognition of loperamide overdose is crucial to prevent severe outcomes like cardiac arrhythmias and multiorgan failure.
  • Clinicians should be aware of the potential for severe toxicity and mortality associated with supratherapeutic loperamide use.