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Loperamide – An Unexpected Drug of Abuse

Does anything surprise us anymore?– Yes, even the over-the-counter antidiarrheal drug, loperamide (Imodium), can be abused.  It is a legal, inexpensive, and accessible alternative for someone with opioid use disorder, or merely curious about the pleasurable effects of opioids.  It…

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Baclofen Overdose or Brain Death?

QUICK FACTS Baclofen reduces muscle tone and spasticity. It has a delayed peak and prolonged half-life in overdose. Deep coma with absent brain stem reflexes may mimic brain death in overdose. Treatment is symptomatic and supportive, there is no antidote.…

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Venlafaxine & Desvenlafaxine Overdose

QUICK FACTS Venlafaxine and desvenlafaxine can cause delayed onset seizures. There is also a risk of serotonin toxicity in overdose. There are active metabolites, so symptoms can be prolonged. Benzodiazepines are the first line treatment to manage seizures.   Venlafaxine…

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Inhalant Abuse

While not particularly in vogue as abused substances, use of inhalants for euphoriant effects caused several dozen toxic cases in Missouri in the last 2 years, including 2 fatalities.
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IV NAC Protocol

Acetaminophen (APAP) is an OTC analgesic/antipyretic found in most medicine cabinets. It is available as a single ingredient or formulated with other OTC or prescription medications. Overdose with APAP is one of the most common poisonings in the US. The FDA-approved 21-hour, three-bag protocol for IV NAC administration is effective; however, there is substantial risk for dosing and administration errors.
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Loperamide Abuse

It may be surprising, but it’s not a myth – yes, even the over-the-counter antidiarrheal drug, loperamide (Imodium), can be abused. For someone addicted to opioids, it may appear to be a legal, inexpensive, and accessible alternative, but the effects can be dangerous, potentially causing life-threatening arrhythmia.
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