The source of a 25-year-old woman's puzzling signs and symptoms could not be determined until a search of her home yielded the answer. She had no known medical problems when she presented to the Emergency Department with a 2-week history of persistent abdominal discomfort. A routine work-up for abdominal pain was unrevealing. An electrocardiogram (ECG) showed sinus rhythm at a rate of 69 beats per minute with a QT interval of 492 ms, a corrected QT interval of 527 ms, an intraventricular conduction defect with a QRS interval of 170 ms, and nonspecific T-wave abnormalities (Figure 1). She was treated symptomatically for abdominal pain and discharged with no medications.
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- “I just wanted to tell you that loperamide WILL WORK:” a web-based study of extra-medical use of loperamide.Drug Alcohol Depend. 2013; 130: 241-244
- Hydrochlorides of N-hydroxyalkyl-alpha-piperidine carboxylic arylamides possessing antiarrhythmic activity.Farmakol Toksikol. 1984; 47: 25-28
- Loperamide blocks high-voltage-activated calcium channels and N-methyl-D-aspartate-evoked responses in rat and mouse cultured hippocampal pyramidal neurons.Mol Pharmacol. 1994; 45: 747-757
- Characterization of the antihyperalgesic action of a novel peripheral mu-opioid receptor agonist—loperamide.Anesthesiology. 1999; 90: 225-234
- Antiarrhythmic and electrophysiologic effects of MDL 11,939, a novel class III antiarrhythmic agent in anesthetized dogs.J Cardiovasc Pharmacol. 1990; 16: 383-393
- Loperamide: blockade of calcium channels as a mechanism for antidiarrheal effects.J Pharmacol Exp Ther. 1984; 231: 628-632
- Systems pharmacology of arrhythmias.Sci Signal. 2010; 3: ra30
- 1274: Loperamide: the unexpected culprit.Crit Care Med. 2013; 41: A328
- On the relationship between block of the cardiac Na+ channel and drug-induced prolongation of the QRS complex.Br J Pharmacol. 2011; 164: 260-273
Published online: June 04, 2015Julia H. Indik, MD, PhD, Section Editor
Conflict of Interest: None.
Authorship: All authors contributed equally to the manuscript.
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- An Additional Clinical Scenario of Risk for Loperamide Cardiac-Induced ToxicityThe American Journal of MedicineVol. 129Issue 4