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Case Reports
. 2019 May 25;11(5):e4753.
doi: 10.7759/cureus.4753.

Loperamide Overdose

Casey Arnold  1 , Carmen J Martinez Martinez  1
Affiliations
Case Reports

Loperamide Overdose

Casey Arnold et al. Cureus. .

Abstract

In light of the opioid epidemic, cardiac complications following a loperamide overdose are a growing concern for patients presenting to the emergency department (ED). Here, we present the case of a 35-year-old male with long QT syndrome who presented following a loperamide overdose and was receiving multiple shocks because of the resulting arrhythmias and electrolyte disturbances. It is necessary for emergency physicians to be aware of loperamide overdoses because cases have been increasing over the past several years and the cardiac complications can be life-threatening.

Keywords: imodium® overdose; long qt syndrome; loperamide overdose; opioid; torsades.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial ECG in the resuscitation room upon arrival
ECG: electrocardiogram
Figure 2
Figure 2. ECG after 5.5 hours of antiarrhythmics (lidocaine) and electrolyte replacement showing a failure to sense and capture
ECG: electrocardiogram
Figure 3
Figure 3. ECG after two days, showing AV dual paced complexes
ECG: electrocardiogram; AV: atrioventricular
Figure 4
Figure 4. ECG 10 days later, when the patient presented back to the ED for routine chest pain workup, showing his baseline atrial paced rhythm restored
ECG: electrocardiogram; ED: emergency department
See this image and copyright information in PMC

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