@article{ref1,
title="Loperamide metabolite-induced cardiomyopathy and QTc prolongation",
journal="Clinical toxicology (Philadelphia, Pa.)",
year="2017",
author="Bhatti, Zabeer and Norsworthy, Jessica and Szombathy, Tamas",
volume="55",
number="7",
pages="659-661",
abstract="Loperamide is an over-the-counter, peripherally acting, μ-opioid receptor agonist used for the treatment of diarrhea. In recent times users have found that at higher doses, loperamide crosses the blood-brain barrier and reaches central μ-receptors in the brain, leading to central opiate effects including euphoria and respiratory depression. We report a case of a 37-year-old female who attempted suicide with over 200 loperamide tablets. During her overdose, her QTc was significantly prolonged at >600 ms. Our case aims to add to the growing body of literature describing life-threatening ventricular arrhythmias associated with loperamide toxicity and further suggests that a metabolite of loperamide, desmethylloperamide, may play a role in the pathogenesis.<p /><p>Language: en</p>",
language="en",
issn="1556-3650",
doi="10.1080/15563650.2017.1304555",
url="http://dx.doi.org/10.1080/15563650.2017.1304555"
}