National assessment of pharmacist awareness of loperamide abuse and ability to restrict sale if abuse is suspected.

@article{Feldman2020NationalAO,
  title={National assessment of pharmacist awareness of loperamide abuse and ability to restrict sale if abuse is suspected.},
  author={Ryan Feldman and Erik Everton},
  journal={Journal of the American Pharmacists Association : JAPhA},
  year={2020}
}
BACKGROUND Reports of loperamide abuse to achieve euphoric effects have been increasing. In September 2019, the Food and Drug Administration stated that manufacturers will limit package sizes of loperamide to reduce inappropriate use. OBJECTIVE We aimed to characterize pharmacist knowledge of loperamide abuse at the point of retail access and determine what pathways pharmacists have throughout the United States to limit the sale of loperamide packages when abuse is suspected. METHODS A… 
Understanding the use of prescription and OTC drugs in obtaining illicit highs and the pharmacist role in preventing abuse
This is accepted text of Understanding the use of prescription and OTC drugs in obtaining illicit highs and the pharmacist role in preventing abuse. The Pharmaceutical Journal, Vol 305, No 7943,

References

SHOWING 1-10 OF 16 REFERENCES
Loperamide misuse and abuse.
TLDR
The potential for loperamide misuse and abuse is increasing in the United States, and pharmacists are encouraged to monitor and restrict their sales.
Loperamide misuse to avoid opioid withdrawal and to achieve a euphoric effect: high doses and high risk
TLDR
The majority of patients with loperamide toxicity due to misuse/abuse, in-line with national trends, had significant cardiovascular effects, including QTc-prolongation and ventricular dysrhythmias.
Abuse potential of loperamide
TLDR
It was concluded that in its present form, i.e., capsules containing loperamide mixed with magnesium stearate, Loperamide poses little threat of potential abuse.
Notes from the Field: Cardiac Dysrhythmias After Loperamide Abuse - New York, 2008-2016.
TLDR
Cases of loperamide abuse reported to the Upstate New York Poison Center and New York City Poison Control Center were analyzed for demographic, exposure, clinical, and laboratory characteristics.
Loperamide dependence and abuse
TLDR
The first case of a patient with loperamide dependence due to misuse of its opiate-like effects achieved by chronic massive oral ingestions is described.
Proarrhythmic mechanisms of the common anti-diarrheal medication loperamide: revelations from the opioid abuse epidemic
TLDR
The present study tested loperamide on the cloned human cardiac sodium channel (Nav1.5) and the two main repolarizing cardiac K+ channels cloned from the human heart: KvLQT1/minK and the human ether-a-go- go-related gene (hERG) channel to determine the mechanisms of this cardiotoxicity.
Potent Inhibition of hERG Channels by the Over-the-Counter Antidiarrheal Agent Loperamide.
TLDR
Loperamide is a potent hERG channel blocker that significantly prolongs the action potential duration and suggests a causal association between loperamide and recent clinical cases of torsade de pointes.
Characterization of loperamide-mediated block of hERG channels at physiological temperature and its proarrhythmia propensity.
TLDR
The combined in vitro and in silico approach provides mechanistic insight regarding the potential for loperamide to generate cardiotoxicity in overdose situations, and holds promise for improving cardiac safety assessment.
Loperamide and P‐glycoprotein inhibition: assessment of the clinical relevance
TLDR
This study searched the literature for papers containing data on drug–drug interactions of loperamide‐containing products in humans and reviewed the internal worldwide safety database of Johnson & Johnson for spontaneous case reports suggestive of a central opioid effect after coadministration of Loperamide with a P‐glycoprotein inhibitor or substrate.
2016 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Annual Report
TLDR
These data support the continued value of PC expertise and need for specialized medical toxicology information to manage more serious exposures, despite a decrease in cases involving less serious exposures.
...
1
2
...