Correct!
5. Loperamide
Loperamide is a widely available anti-diarrheal medication that is becoming more popular amongst patients suffering from opioid misuse disorder (2,3). In therapeutic dosing, its opioid mu agonistic effects are localized to the GI tract, causing decreased gut motility and resolution of diarrhea. In overdose, however, loperamide is able to cross into the central nervous system, where it exerts central opioid effects. This leads to the classic opioid toxidrome of decreased respirations, decreased mentation, and decreased pupil size. Loperamide also acts on cardiac myocytes via blockade of potassium (hERG) channels, which leads to prolonged QT and Torsade de Pointes.
After pacemaker placement, the patient was successfully electrically overdrive paced.
Which over-the-counter product is commonly used to increase the desired effects of the medication on which this patient overdosed? (Click on the correct answer to be directed to the fifth of seven pages)