skip to main content

Acute infectious diarrhoea red flags — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardGastro-intestinal TherapeuticsAcute infectious diarrhoea red flagsGPhC CRA

A patient has taken 24 mg of loperamide daily for several days and now has palpitations and near-syncope. Which ECG pattern most strongly supports excessive-loperamide cardiotoxicity?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — QRS widening with QTc prolongation and ventricular ectopy

Excess loperamide has caused both QRS and QT prolongation, torsades de pointes and other ventricular arrhythmias, syncope and cardiac arrest. QRS widening with QTc prolongation and ventricular ectopy therefore fits the recognised pattern. Loperamide should be stopped and urgent emergency assessment with ECG monitoring arranged.

Reference: Loperamide 2 mg orodispersible tablets SmPC: https://www.medicines.org.uk/emc/product/101779/smpc