Unexpected Serious Cardiac Arrhythmias in the Setting of Loperamide Abuse

摘要

Loperamide (Imodium) is a non-prescription opioid receptoragonist available over-the-counter for the treatmentof diarrhea. When ingested in excessive doses,loperamide can penetrate the blood-brain barrier and isreported to produce euphoria, central nervous system andrespiratory depression, and cardiotoxicity. There is anemerging trend in its use among drug abusers for its euphoriceffects or for self-treatment of opioid withdrawal.We report a case of ventricular dysrhythmias associatedwith loperamide abuse in a 28-year-old man who substitutedloperamide for the opioids that he used to abuse.