reflexor
Bluelighter
- Joined
- Jul 12, 2022
- Messages
- 43
I’ll start by saying that this case does not involve myself but a 35 year old man who was a highlighted case. I’m going to share with you his experience in taking significant amounts of Loperamide, which is known by the brand name Imodium, to kick a heroin addiction but more realistically just postpone
withdrawal.
As a quick summary - Loperamide is a potent opioid that cannot pass the blood brain barrier in therapeutic doses (it does attach to GI opioid receptors slowing GI movement). But is euphoric in doses significantly higher than the therapeutic range, most often 50-200 times the therapeutic range.
It turns out this man got far more than he bargained for and did not heed the warnings of cardiotoxicity and remained complacent in the face of an ultimatum: go through the hell of heroin withdrawal or try his luck with Lope Dope. I’m sure you already know what he chose.
TRIP REPORT
I’ll talk about some general analysis I have have collated, my words do not have the intention to scare or induce anxiety. However, I will tell you now - if you have taken a significantly high dose of loperamide recently and you felt “off” enough to research the side effects on bluelight - I would not continue reading this and work yourself up into an unrelated heart attack; please just call an ambulance or get someone to drive you to an ER because you can very easily die and far too many have died from complacency.
In a highlighted case study, a 35 year old male who overdosed on loperamide, the study describes the patient in the ER even after receiving naloxone, an IV drip of anti-arrhythmic’s as “anxious and diaphoretic and was shocked by his defibrillator every three to four minutes for runs of polymorphic ventricular tachycardia (PVT)” - PVT is very similar to the often fatal arrhythmia torsades de pointes, given this patient had long QT intervals on his ECG, he was definitely at risk of developing torsades de pointes which is actually just a type of PVT that strikes fear into medical professionals (it sounds menacing).
Even after 5.5 hours since arriving in the ER and having been resuscitated frequently for the entirety of his stay, this is the relevant ECG, I invite you to compare this to a normal sinus rhythm (just search normal sinus rhythm in google)
ECG after 5.5 hours of antiarrhythmics (lidocaine) https://i.imgur.com/3KA0NSl.jpeg and electrolyte replacement showing a failure to sense and capture
If you are like me and have experience reading ECG’s - then you know that this is a truly terrifying and horrific experience for the patient. The leads are clearly showing that the electrical signals to the heart are out of sync - we assume that the automated internal cardiac defibrillator (AICD) shocks and resets leads 1, 2 and 3 (noted by the normal sinus rhythm anenelectrical activity on the EKG and a subsequent normal sinus rhythm for those leads). However, the AICD was not able to catch the fourth lead which means just to deliver a shock; we know this because there is no absence of electrical activity at the same time as leads 1,2,3 and also, lead 4 was not reset into a normal sinus rhythm. The heart is a sturdy organ, but the heart becomes very delicate when disresepected, lead 4’s electrical system will likely bring back arrhythmia and eventually cause the other leads to be asynced. What’s worse, his AICD isn’t working all the time as shown. Even more horrible, this poor man has to go home, in full opioid withdrawal, still worrying about his heart. It is torture.
Seriously, I strongly encourage any of you considering taking loperamide - just actually think about the terror of having your heart resuscitated dozens of times in a busy ER. It is NOT like being punched lightly in the chest, it is a very high voltage electric shock and it fucking hurts! Plus the nurses and doctors don’t feel sorry for you the same way as if you’d just broken a leg by accident, instead you’re the scumbag taking a weak, toxic, shitty diarrhoea drug to get a high or to postpone withdrawal that you will face eventually and will suck either way.
Here is our patients ECG when he first came to the ER, he was conscious but so agitated and anxious that he couldn’t speak - keep that in mind before you swallow one hundred pills like they’re skittles:
Initial ECG in the resuscitation room upon arrival
There are just so many things wrong with this EKG, just by briefly looking I can see that he may have atrial fibrillation/tachycardia due to the close proximity of the t and p wave (it’s very hard to distinguish the t wave so I’m not sure).
We can also see in some leads we have an elevated S wave without a clear trough or a trough without a clear elevation: this is classic right ventricular hypertrophy which is the thickening of the right ventricular walls. It can be caused by a number of different factors including heart valve disease, pulmonary hypertension, congenital heart defects, lung disease, genetic factors and probably more. Recent studies also suggest anxiety plays a big role in causing exacerbation of the symptoms of right ventricular hypertrophy (sorry I don’t know the citations).
One more point regarding the EKG above, in lead one you can see best, the curved appearance of the QRS complex, it should not look like this because there are meant to be immediate delays after contractions which is controlled by the atrioventricular nodes (AV nodes) and if the R to S line isn’t straight down, then the other chambers are misfiring due to something called an AV block where the random signals are not being depressed by the AV nodes. In this patients case we would probably call it AV block with premature ventricular contractions - which isn’t necessarily a harmful condition but when combined with everything else this patient has given themselves through his friend Lope Dope - it is seriously dangerous. Also to reiterate the seriousness of this overdose: if you look at both EKG’s you can see that the Q wave and the T wave are very far apart (when going left to right), this is called long QT syndrome and with this patients other symptoms - the risk of torsades de pointes is high. Torsades de pointes is a chaotic arrhythmia that kind of looks like a corkscrew on an EKG and will very often result in cardiac arrest and a requirement for resuscitation. This man was incredibly lucky to survive this overdose and the fact that his heart was able to be resuscitated so many times is truly a miracle - but don’t test it out!.
Hope I was able to be informative and have persuaded at least one of you to heed the warning, I promise you, it won’t be a good experience.
I’m sorry for using both ECG and EKG haha, I often just use a random one, ECG and EKG are the exact same thing - sorry if I confused you!
Case Study Used
withdrawal.
As a quick summary - Loperamide is a potent opioid that cannot pass the blood brain barrier in therapeutic doses (it does attach to GI opioid receptors slowing GI movement). But is euphoric in doses significantly higher than the therapeutic range, most often 50-200 times the therapeutic range.
It turns out this man got far more than he bargained for and did not heed the warnings of cardiotoxicity and remained complacent in the face of an ultimatum: go through the hell of heroin withdrawal or try his luck with Lope Dope. I’m sure you already know what he chose.
TRIP REPORT
I’ll talk about some general analysis I have have collated, my words do not have the intention to scare or induce anxiety. However, I will tell you now - if you have taken a significantly high dose of loperamide recently and you felt “off” enough to research the side effects on bluelight - I would not continue reading this and work yourself up into an unrelated heart attack; please just call an ambulance or get someone to drive you to an ER because you can very easily die and far too many have died from complacency.
In a highlighted case study, a 35 year old male who overdosed on loperamide, the study describes the patient in the ER even after receiving naloxone, an IV drip of anti-arrhythmic’s as “anxious and diaphoretic and was shocked by his defibrillator every three to four minutes for runs of polymorphic ventricular tachycardia (PVT)” - PVT is very similar to the often fatal arrhythmia torsades de pointes, given this patient had long QT intervals on his ECG, he was definitely at risk of developing torsades de pointes which is actually just a type of PVT that strikes fear into medical professionals (it sounds menacing).
Even after 5.5 hours since arriving in the ER and having been resuscitated frequently for the entirety of his stay, this is the relevant ECG, I invite you to compare this to a normal sinus rhythm (just search normal sinus rhythm in google)
ECG after 5.5 hours of antiarrhythmics (lidocaine) https://i.imgur.com/3KA0NSl.jpeg and electrolyte replacement showing a failure to sense and capture
If you are like me and have experience reading ECG’s - then you know that this is a truly terrifying and horrific experience for the patient. The leads are clearly showing that the electrical signals to the heart are out of sync - we assume that the automated internal cardiac defibrillator (AICD) shocks and resets leads 1, 2 and 3 (noted by the normal sinus rhythm anenelectrical activity on the EKG and a subsequent normal sinus rhythm for those leads). However, the AICD was not able to catch the fourth lead which means just to deliver a shock; we know this because there is no absence of electrical activity at the same time as leads 1,2,3 and also, lead 4 was not reset into a normal sinus rhythm. The heart is a sturdy organ, but the heart becomes very delicate when disresepected, lead 4’s electrical system will likely bring back arrhythmia and eventually cause the other leads to be asynced. What’s worse, his AICD isn’t working all the time as shown. Even more horrible, this poor man has to go home, in full opioid withdrawal, still worrying about his heart. It is torture.
Seriously, I strongly encourage any of you considering taking loperamide - just actually think about the terror of having your heart resuscitated dozens of times in a busy ER. It is NOT like being punched lightly in the chest, it is a very high voltage electric shock and it fucking hurts! Plus the nurses and doctors don’t feel sorry for you the same way as if you’d just broken a leg by accident, instead you’re the scumbag taking a weak, toxic, shitty diarrhoea drug to get a high or to postpone withdrawal that you will face eventually and will suck either way.
Here is our patients ECG when he first came to the ER, he was conscious but so agitated and anxious that he couldn’t speak - keep that in mind before you swallow one hundred pills like they’re skittles:
Initial ECG in the resuscitation room upon arrival
There are just so many things wrong with this EKG, just by briefly looking I can see that he may have atrial fibrillation/tachycardia due to the close proximity of the t and p wave (it’s very hard to distinguish the t wave so I’m not sure).
We can also see in some leads we have an elevated S wave without a clear trough or a trough without a clear elevation: this is classic right ventricular hypertrophy which is the thickening of the right ventricular walls. It can be caused by a number of different factors including heart valve disease, pulmonary hypertension, congenital heart defects, lung disease, genetic factors and probably more. Recent studies also suggest anxiety plays a big role in causing exacerbation of the symptoms of right ventricular hypertrophy (sorry I don’t know the citations).
One more point regarding the EKG above, in lead one you can see best, the curved appearance of the QRS complex, it should not look like this because there are meant to be immediate delays after contractions which is controlled by the atrioventricular nodes (AV nodes) and if the R to S line isn’t straight down, then the other chambers are misfiring due to something called an AV block where the random signals are not being depressed by the AV nodes. In this patients case we would probably call it AV block with premature ventricular contractions - which isn’t necessarily a harmful condition but when combined with everything else this patient has given themselves through his friend Lope Dope - it is seriously dangerous. Also to reiterate the seriousness of this overdose: if you look at both EKG’s you can see that the Q wave and the T wave are very far apart (when going left to right), this is called long QT syndrome and with this patients other symptoms - the risk of torsades de pointes is high. Torsades de pointes is a chaotic arrhythmia that kind of looks like a corkscrew on an EKG and will very often result in cardiac arrest and a requirement for resuscitation. This man was incredibly lucky to survive this overdose and the fact that his heart was able to be resuscitated so many times is truly a miracle - but don’t test it out!.
Hope I was able to be informative and have persuaded at least one of you to heed the warning, I promise you, it won’t be a good experience.
I’m sorry for using both ECG and EKG haha, I often just use a random one, ECG and EKG are the exact same thing - sorry if I confused you!
Case Study Used
