Loperamide (Imodium) overdose can cause fatal cardiac toxicity

A recent paper described two fatalities associated with overdose of the anti-diarrhea drug loperamide (Imodium.) This drug, once available by prescription only, had been thought so safe that in 1988 it was approved for purchase over-the-counter. Here are some important questions regarding this medication: Why is it sometimes called the “poor man’s methadone”? Why, despite having typical opiate μ-receptor activity, does it generally not cause respiratory or mental status depression? Why is P-glycoprotein (P-gp) important for understanding the pharmacokinetics of loperamide, and what does that have to do with Mr. T? What are the important cardiotoxic effects of loperamide? Why did the FDA recently issue a safety alert warning of “Serious heart problems” that could result from loperamide overdose? The answers to these questions, and more, can be found in my “Toxicology Rounds” column this month in Emergency Medicine News. To read it, click here. Related post: Cardiac effects of loperamide overdose  
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical cardiotoxicity imodium loperamide opiate P-glycoprotein Source Type: news

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IMPORTANCE: Prior lethality analyses of suicide means have historically treated drug poisoning other than alcohol poisoning as a lumped category. Assessing risk by drug class permits better assessment of prevention opportunities. OBJECTIVE: To inve...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Abstract In 2011, Florida established a Prescription Drug Monitoring Program and adopted new regulations for independent pain-management clinics. This paper examines the association of those reforms with drug overdose deaths and other injury fatalities. Florida's post-reform monthly mortality rates - for drug-involved deaths, motor vehicle crashes, and suicides by means other than poisoning - were compared to a counterfactual estimate of what those rates would have been absent reform. The counterfactual was estimated using a Bayesian structural time-series model based on mortality trends in similar states. By Dece...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
Self-poisoning accounts for a significant number of attendances to acute services. It can occur at any age. The reasons that lead someone to self-poison are variable and individual. It is often a manifestation of distress. Women are more likely to present, or die, after overdose than men, although men are more likely to die by suicide overall. Self-harm, including self-poisoning, is a strong risk factor and antecedent to suicide. Psychosocial assessment offers an important opportunity to intervene.
Source: Medicine - Category: Internal Medicine Authors: Tags: General aspects of poisoning Source Type: research
Alcohol poisoning is a serious medical emergency due to the overconsumption of alcohol that can result in death. Overconsumption of alcohol affects many systems in the body. The liver, which works to eliminate toxins from the body, is not able to keep up with the high amount being ingested. In turn, the central nervous system becomes so depressed to the point that it cannot perform its normal, essential functions such as beating the heart and breathing. There are many factors that can determine whether or not an individual could suffer from alcohol poisoning, such as: Rate of alcohol consumption Tolerance and dependency ...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcohol Alcohol Rehab Information Alcoholism Detox Resources for Alcohol and Drugs/Opiates alcohol abuse alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility Source Type: blogs
Conclusions: DUIMS indicates higher mortality, and DUIMS' profiles in causes of death differ from the general population. Elevated risk for, for instance, suicidal, accidental and violent death among those using multiple substances highlights the need to also pay attention to causes of death other than poisoning/overdose. PMID: 31856686 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Public Health - Category: International Medicine & Public Health Authors: Tags: Scand J Public Health Source Type: research
Having a concussion within the past year may raise the risk of suicidal ideation and behavior in high school students, according to astudy in theJournal of Affective Disorders.Dale S. Mantey, M.P.A., of the University of Texas School of Public Health and colleagues used data from more than 13,000 respondents in grades 9 through 12 who participated in the 2017 Youth Risk Behavior Surveillance Survey (YRBSS). The national YRBSS is conducted every two years by the Centers for Disease Control and Prevention to monitor health behaviors that contribute to the leading causes of death, disability, and social problems among youth a...
Source: Psychiatr News - Category: Psychiatry Tags: concussion Dale Mantey depressive symptoms Journal of Affective Disorders suicide Youth Risk Behavior Surveillance Survey Source Type: research
ConclusionsCause of death of the male corpse was deemed to be due to heroin intoxication as the blood concentration of morphine was more than the lethal concentration with a morphine/codeine ratio of more than 1:1. Methomyl intoxication of the male corpse was unlikely to be the cause of death because methomyl systemic blood concentration was found to be very low,
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Between 1991 and 2017, the rate of black adolescents who reported attempting suicide rose, according to areport published Monday inPediatrics. This trend was not seen in adolescents who identified as white, Hispanic, Asian American or Pacific Islander, or being of multiple races.“Examining trends in suicidal ideation and behaviors over time by sex and race and ethnicity allows us to determine where to focus prevention and intervention efforts,” wrote Michael A. Lindsey, Ph.D., M.S.W., M.P.H., of New York University and colleagues.Lindsey and colleagues analyzed data from the Youth Risk Behavior Survey (YRBS) &m...
Source: Psychiatr News - Category: Psychiatry Tags: adolescents Benjamin Shain Michael Lindsey pediatrics suicide attempt suicide ideation Youth Risk Behavior Survey Source Type: research
CONCLUSIONS: Combining drug classes with alcohol prior to OD was common and associated with a higher likelihood of hospitalization. Overdose prevention efforts should address acute risks of alcohol ingestion with other drugs. PMID: 31596516 [PubMed - as supplied by publisher]
Source: Alcoholism, Clinical and Experimental Research - Category: Addiction Authors: Tags: Alcohol Clin Exp Res Source Type: research
We sought to identify trends in overdoses with over-the-counter (OTC) dextromethorphan (DXM) cough preparations among adolescents from a national poison center surveillance database. Our objective was to identify both severity of outcomes and trends in adolescent suicide attempts with OTC DXM cough preparations.
Source: Journal of the American Academy of Child and Adolescent Psychiatry - Category: Psychiatry Authors: Source Type: research
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