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10.1002/jcph.1449 http://scihub22266oqcxt.onion/10.1002/jcph.1449 31116446!ä!31116446 Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Clin+Pharmacol 2019 ; 59 (9): 1165-1169 Nephropedia Template TP {{tp|p=31116446|t=2019. Loperamide: A Readily Available but Dangerous Opioid Substitute |pdf=|usr=}}{{31116446}} gab.com Text Loperamide: A Readily Available but Dangerous Opioid Substitute JO: J Clin Pharmacol http://www.kidney.de/pget.php?&tw=1&pmid=31116446 #FOAvip The antidiarrheal over-the-counter drug loperamide is increasingly being used to control opioid withdrawal or for opioid abuse. Taking many times above the normally recommended dose is dangerous with cardiovascular, respiratory, and neurological adverse events. Cytochrome P-450 (CYP)2C8, CYP3A, and P-glycoprotein inhibitors can increase the plasma and central nervous system concentrations and radically alter the risk profile of loperamide. Online forums suggest using over-the-counter metabolic enzyme blockers to enhance the effects. Public health options include switching over-the-counter loperamide to blister packs (the FDA-preferred method), making loperamide only available by prescription, or moving the product behind the pharmacy counter. Although naloxone may ameliorate the neurological and respiratory adverse events, it is ineffective at reversing loperamide-induced arrhythmias. Even magnesium might provide less efficacy in loperamide-induced Torsade de Pointes necessitating the use of cardiac pacing and electrical cardioversion. Twit Text FOAVip Loperamide: A Readily Available but Dangerous Opioid Substitute ????J Clin Pharmacol http://www.kidney.de/pget.php?&tw=1&pmid=31116446 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=31116446 #FOAvip English Wikipedia <ref>{{Cite pmid|31116446}}</ref> Loperamide: A Readily Available but Dangerous Opioid Substitute #MMPMID31116446 White CM J Clin Pharmacol 2019[Sep]; 59 (9): 1165-1169 PMID31116446show ga The antidiarrheal over-the-counter drug loperamide is increasingly being used to control opioid withdrawal or for opioid abuse. Taking many times above the normally recommended dose is dangerous with cardiovascular, respiratory, and neurological adverse events. Cytochrome P-450 (CYP)2C8, CYP3A, and P-glycoprotein inhibitors can increase the plasma and central nervous system concentrations and radically alter the risk profile of loperamide. Online forums suggest using over-the-counter metabolic enzyme blockers to enhance the effects. Public health options include switching over-the-counter loperamide to blister packs (the FDA-preferred method), making loperamide only available by prescription, or moving the product behind the pharmacy counter. Although naloxone may ameliorate the neurological and respiratory adverse events, it is ineffective at reversing loperamide-induced arrhythmias. Even magnesium might provide less efficacy in loperamide-induced Torsade de Pointes necessitating the use of cardiac pacing and electrical cardioversion. |Analgesics, Opioid/*adverse effects/*therapeutic use[MESH] |Animals[MESH] |Antidiarrheals/adverse effects/therapeutic use[MESH] |Humans[MESH] |Loperamide/*adverse effects/*therapeutic use[MESH] |Naloxone/adverse effects/therapeutic use[MESH] |Substance Withdrawal Syndrome/drug therapy[MESH]Loperamide: A Readily Available but Dangerous Opioid Substitute (epmc).pdf DeepDyve Pubget Overpricing