Loperamide toxicity: Difference between revisions
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==Management== | ==Management== | ||
*Supportive care / standard [[ACLS]] | |||
*Consider: | |||
**[[Overdrive pacing]] | |||
**[[Intravenous lipid emulsion]] | |||
**[[Extracorporeal membrane oxygenation]] | |||
==Disposition== | ==Disposition== | ||
Revision as of 07:20, 14 August 2017
Background
- Increasing reports of intentional overdose at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal[1]
Clinical Features
- May have features of conventional opioid toxicity
Loperamide-induced cardiac toxicity[2]
- Often young
- May present in cardiac arrest or with recurrent syncope in conjunction with ECG agnormalities
Differential Diagnosis
Sedative/hypnotic toxicity
- Absinthe
- Barbiturates
- Benzodiazepines
- Chloral hydrate
- Gamma hydroxybutyrate (GHB)
- Baclofen toxicity
- Opioids
- Toxic alcohols
- Xylazine toxicity
Evaluation
ECG Findings
- QT prolongation
- QRS widening
- Ventricular dysrhythmias
Management
- Supportive care / standard ACLS
- Consider: