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from the Antidiarrheal-overdose?-Oh,-crap! dept.
NPR is reporting on the latest drug scare, involving an over-the-counter antidiarrheal drug that is being used for its opioid-like effects by addicts:
Some people addicted to oxycodone and other opioids are now turning to widely available diarrhea medications to manage their withdrawal symptoms or get high. The results can be dangerous to the heart — and sometimes fatal — warn toxicologists in a study [open, DOI: 10.1016/j.annemergmed.2016.03.047] recently published online in the Annals of Emergency Medicine.
The researchers describe two case studies where people who were addicted to opioids tried to ease their withdrawal symptoms by taking many times the recommended dose of loperamide, a drug commonly used treat diarrhea. Both patients died.
"Because of its low cost, ease of accessibility and legal status, it's a drug that is very, very ripe for abuse," says lead author William Eggleston, a doctor of pharmacy and fellow in clinical toxicology at the Upstate New York Poison Center, which is affiliated with SUNY Upstate Medical University.
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(Score: 2) by EvilSS on Wednesday May 04 2016, @06:22PM
Like someone else said, it's not damage so much as acute dysfunction resulting from overdose. Turns out it's not only causing the expected opioid response of central nervous system depression but also causing heart arrhythmias. The study in the paper in the summary is pretty comprehensive, but this is the meat of it:
In addition to clinical manifestations consistent with opioid toxicity (miosis, central nervous system depression, and respiratory depression), significant cardiac dysrhythmias have been reported after overdose. Ventricular dysrhythmias, including polymorphic ventricular tachycardia, as well as prolongation of the QRS complex and QTc duration, have occurred in patients after supratherapeutic loperamide ingestions. Loperamide has been shown to inhibit human cardiac sodium channels in vitro, and QRS prolongation in the overdose setting suggests that this interaction also occurs in vivo. Loperamide inhibits delayed-rectifier potassium currents in vitro. Xenobiotics that inhibit delayed-rectifier potassium currents can prolong the QTc duration and increase the risk for polymorphic ventricular tachycardia, both of which have been reported after oral loperamide overdose. Additionally, loperamide is known to inhibit calcium channels, which may contribute to cardiac toxicity in overdose.1 Fatality associated with loperamide abuse has been reported; however, confirmed death caused by loperamide has not been reported outside of the forensic toxicology literature.