A Case Report of Cardiogenic Syncope Due to Loperamide Abuse: Acute Presentation and Novel Use of Buprenorphine

Introduction: Loperamide is a non-prescription anti-diarrheal agent targeting µ-opioid receptors in the intestinal tract. At high doses it crosses the blood-brain barrier, where µ-opioid agonism can cause euphoric effects. Misuse has been increasing for both the euphoric effects and as an alternativ...

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Published inClinical practice and cases in emergency medicine Vol. 5; no. 2; pp. 214 - 217
Main Authors Betting, David, Chenoweth, James, Jarman, Angela
Format Journal Article
LanguageEnglish
Published Irvine University of California Digital Library - eScholarship 10.05.2021
University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
eScholarship Publishing, University of California
Subjects
Blood-brain barrier
Cardiac arrhythmia
Case Report
Clinical medicine
Drug dosages
Drug withdrawal
Electrocardiography
Electrolytes
Emergency medical care
Gambling
Glycoproteins
Heart rate
Medicine
Methadone
Narcotics
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Summary:Introduction: Loperamide is a non-prescription anti-diarrheal agent targeting µ-opioid receptors in the intestinal tract. At high doses it crosses the blood-brain barrier, where µ-opioid agonism can cause euphoric effects. Misuse has been increasing for both the euphoric effects and as an alternative treatment for opioid dependence and withdrawal. Case Report: Here we report the case of a 30-year-old woman presenting with syncope, who was found to have severe myocardial conduction delays in the setting of chronic loperamide abuse. Conclusion: Treatment with sodium bicarbonate and hypertonic sodium resulted in improvement of her conduction abnormalities. Prior to discharge she was initiated on buprenorphine for her opioid use disorder.
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ISSN:2474-252X
2474-252X
DOI:10.5811/cpcem.2021.3.51152