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Not your regular high: cardiac dysrhythmias caused by loperamide

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Pages 454-458 | Received 08 Dec 2015, Accepted 23 Feb 2016, Published online: 29 Mar 2016

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Read on this site (4)

Brandon Masi Parker, Tejaus Rao, Ann Matta, Megan Quitanna, H. Neal Reynolds, Deborah M Stein & Daniel Haase. (2019) Loperamide induced cardiac arrhythmia successfully supported with veno-arterial ECMO (VA-ECMO), molecular adsorbent recirculating system (MARS) and continuous renal replacement therapy (CRRT). Clinical Toxicology 57:11, pages 1118-1122.
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Justin P. Reinert & Rebecca L. Dunn. (2019) Management of overdoses of loperamide, gabapentin, and modafinil: a literature review. Expert Review of Clinical Pharmacology 12:9, pages 901-908.
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Vincent R. Lee, Ariel Vera, Andreia Alexander, Bruce Ruck, Lewis S. Nelson, Paul Wax, Sharan Campleman, Jeffrey Brent & Diane P. Calello. (2019) Loperamide misuse to avoid opioid withdrawal and to achieve a euphoric effect: high doses and high risk. Clinical Toxicology 57:3, pages 175-180.
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Cornel N. Stanciu & Samantha A. Gnanasegaram. (2017) Loperamide, the “Poor Man’s Methadone”: Brief Review. Journal of Psychoactive Drugs 49:1, pages 18-21.
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Articles from other publishers (31)

Hua Rong Lu, Bruce P. Damiano, Mohamed Kreir, Jutta Rohrbacher, Henk van der Linde, Tamerlan Saidov, Ard Teisman & David J. Gallacher. (2023) The Potential Mechanisms behind Loperamide-Induced Cardiac Arrhythmias Associated with Human Abuse and Extreme Overdose. Biomolecules 13:9, pages 1355.
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Gregory G. Jackson, Christine R. Lopez, Elizabeth S. Bermudez, Nina E. Hill, Dan M. Roden, E. Wesley Ely & Joanna L. Stollings. (2021) Loperamide Induced Recurrent Torsades de Pointes: A Case Report. Journal of Pharmacy Practice 35:5, pages 791-795.
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Peter E. Wu & David N. Juurlink. (2022) Loperamide Cardiac Toxicity: Pathophysiology, Presentation, and Management. Canadian Journal of Cardiology 38:9, pages 1378-1383.
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Julian Wolfes, Christian Ellermann, Sophie Burde, Patrick Leitz, Nils Bögeholz, Kevin Willy, Michael Fehr, Florian Reinke, Lars Eckardt & Gerrit Frommeyer. (2020) Divergent Electrophysiological Effects of Loperamide and Naloxone in a Sensitive Whole-Heart Model. Cardiovascular Toxicology 21:3, pages 248-254.
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Eric J. Lavonas & Cameron Dezfulian. (2020) Impact of the Opioid Epidemic. Critical Care Clinics 36:4, pages 753-769.
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Lauren Strzyzewski, Phillip Key, Prentiss Jones & Joseph A. Prahlow. (2020) Loperamide Abuse and Its Sequelae. American Journal of Forensic Medicine & Pathology 41:3, pages 207-210.
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Bridget Onders & Kurt Neltner. 2020. Case Studies in Emergency Medicine. Case Studies in Emergency Medicine 341 349 .
Monica R Hill, Mark R Hopkins & Claire E Knezevic. (2019) Emerging Toxidromes: A 25-Year-Old Woman with Syncope and ECG Changes. Clinical Chemistry 65:11, pages 1357-1360.
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Todd Teigeler, Heather Stahura, Rizwan Alimohammad, Gautham Kalahasty, Jayanthi N. Koneru, Michael Ellenbogen, Kenneth A. Ellenbogen & Santosh K. Padala. (2019) Electrocardiographic changes in loperamide toxicity: Case report and review of literature. Journal of Cardiovascular Electrophysiology 30:11, pages 2618-2626.
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Kolawole A. Olofinsan, Rafiat A. Ajala‐Lawal & Taofeek O. Ajiboye. (2018) Loperamide‐induced cardiotoxicity in rats: Evidence from cardiac and oxidative stress biomarkers. Journal of Biochemical and Molecular Toxicology 33:4.
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David V. Gauvin, Zachary J. Zimmermann & Theodore J. Baird. (2019) In further defense of nonclinical abuse liability testing of biologics. Regulatory Toxicology and Pharmacology 101, pages 103-120.
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Mário L de Lemos, Jolene Guenter & Victoria Kletas. (2017) Loperamide and cardiac events: Is high-dose use still safe for chemotherapy-induced diarrhea?. Journal of Oncology Pharmacy Practice 24:8, pages 634-636.
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Michael S. Toce, Peter R. Chai, Michele M. Burns & Edward W. Boyer. (2018) Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity. Journal of Medical Toxicology 14:4, pages 306-322.
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Asim Ahmed, Scott Freeland, Leonard Steinberg & Eric N. Prystowsky. (2018) Wide complex tachycardia and cardiomyopathy: What would you do?. Journal of Cardiovascular Electrophysiology 29:8, pages 1171-1173.
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Adrienne Hughes, Robert G. Hendrickson, Betty Chia-Chi Chen & Matthew Valento. (2018) Severe loperamide toxicity associated with the use of cimetidine to potentiate the “high”. The American Journal of Emergency Medicine 36:8, pages 1527.e3-1527.e5.
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Fabrizio Schifano, Stefania Chiappini, John Corkery & Amira Guirguis. (2018) Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review. Brain Sciences 8:4, pages 73.
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Tamer Akel & Soad Bekheit. (2018) Loperamide cardiotoxicity: “A Brief Review”. Annals of Noninvasive Electrocardiology 23:2, pages e12505.
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Julien J. Cavanagh & Teresa Y. Smith. 2018. Quick Guide to Psychiatric Emergencies. Quick Guide to Psychiatric Emergencies 193 198 .
Jiansong Sheng, Phu N. Tran, Zhihua Li, Sara Dutta, Kelly Chang, Thomas Colatsky & Wendy W. Wu. (2017) Characterization of loperamide-mediated block of hERG channels at physiological temperature and its proarrhythmia propensity. Journal of Pharmacological and Toxicological Methods 88, pages 109-122.
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Kenneth D. Katz, Robert D. Cannon, Matthew D. Cook, Alexandra Amaducci, Ryan Day, Joshua Enyart, Glenn Burket, Lauren Porter, Timothy Roach, Jennifer Janssen & Karl E. Williams. (2017) Loperamide-Induced Torsades de Pointes: A Case Series. The Journal of Emergency Medicine 53:3, pages 339-344.
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Neeraj Chhabra & Steven E. Aks. (2017) Current Opiate and Opioid Hazards in Children and Adolescents. Clinical Pediatric Emergency Medicine 18:3, pages 173-180.
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Peter E. Wu & David N. Juurlink. (2017) Clinical Review: Loperamide Toxicity. Annals of Emergency Medicine 70:2, pages 245-252.
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Stephen W. Borron, Susan H. Watts, Jonathan Tull, Salvador Baeza, Stephanie Diebold & Alison Barrow. (2017) Intentional Misuse and Abuse of Loperamide: A New Look at a Drug with “Low Abuse Potential”. The Journal of Emergency Medicine 53:1, pages 73-84.
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Maria Katselou, Ioannis Papoutsis, Panagiota Nikolaou, Artemisia Dona, Chara Spiliopoulou & Sotiris Athanaselis. (2017) “Poor man’s methadone” can kill the poor man. Extra-medical uses of loperamide: a review. Forensic Toxicology 35:2, pages 217-231.
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Heather Miller, Ladan Panahi, Daniel Tapia, Andrew Tran & John D. Bowman. (2017) Loperamide misuse and abuse. Journal of the American Pharmacists Association 57:2, pages S45-S50.
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J. Priyanka Vakkalanka, Nathan P. Charlton & Christopher P. Holstege. (2017) Epidemiologic Trends in Loperamide Abuse and Misuse. Annals of Emergency Medicine 69:1, pages 73-78.
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Noha Al-Qasmi, M. Tahir Soomro, M. Aslam, Ateeq Ur Rehman, Shahid Ali, Ekram Y. Danish, Iqbal M.I. Ismail & A. Hameed. (2016) The efficacy of the ZnO:α-Fe2O3 composites modified carbon paste electrode for the sensitive electrochemical detection of loperamide: A detailed investigation. Journal of Electroanalytical Chemistry 783, pages 112-124.
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Stanley Nattel. (2016) An Emerging Malignant Arrhythmia Epidemic Due to Loperamide Abuse. JACC: Clinical Electrophysiology 2:7, pages 790-792.
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Michael G. Klein, Mark C.P. Haigney, Philip S. Mehler, Naheed Fatima, Thomas P. Flagg & Mori J. Krantz. (2016) Potent Inhibition of hERG Channels by the Over-the-Counter Antidiarrheal Agent Loperamide. JACC: Clinical Electrophysiology 2:7, pages 784-789.
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William Eggleston, Jeanna M Marraffa, Christine M Stork, Maria Mercurio-Zappala, Mark K Su, Rachel S Wightman, Karen R Cummings & Joshua G Schier. (2016) Notes from the Field : Cardiac Dysrhythmias After Loperamide Abuse — New York, 2008–2016 . MMWR. Morbidity and Mortality Weekly Report 65:45, pages 1276-1277.
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Jiesheng Kang, David R. Compton, Roy J. Vaz & David Rampe. (2016) Proarrhythmic mechanisms of the common anti-diarrheal medication loperamide: revelations from the opioid abuse epidemic. Naunyn-Schmiedeberg's Archives of Pharmacology 389:10, pages 1133-1137.
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