\u00ae for Overdoses<\/strong><\/p>\nIntralipid<\/p>\n
\u00ae (lipid emulsion) is intravenous fat emulsion used to supplement parenteral nutrition, but has been<\/p>\n
studied as a possible salvaging therapy for certain overdoses. Intralipid<\/p>\n
\u00ae is composed of triglycerides, phospholipids<\/p>\n
and choline. Intralipid<\/p>\n
\u00ae forms chylomicron-like droplets in the serum that may act as a \u0093sink\u0094 for<\/p>\n
lipid soluble toxins. The toxins distribute into the chylomicrons, away from binding sites and target organs of<\/p>\n
toxicity. Intralipid<\/p>\n
\u00ae may also modulate cardiac energy and improve calcium channel functioning, but these<\/p>\n
effects are felt to be minor.<\/p>\n
Intralipid<\/p>\n
\u00ae use has been studied in animal models of bupivicaine, verapamil, clomipramine and propranolol<\/p>\n
cardiotoxicity. Human case reports of successful use of Intralipid<\/p>\n
\u00ae for bupivacaine, ropivacaine and bupropion\u0096<\/p>\n
induced cardiac arrest are published. It is important to remember that current human data are limited<\/p>\n
on this experience. At this point, Intralipid<\/p>\n
\u00ae is only indicated if the patient suffers from a cardiac arrest<\/p>\n
from an exposure to the following:<\/p>\n
Intralipid<\/p>\n
\u00ae 20% is given as an intravenous bolus in a dose of 1.5 mL\/kg over 1 min. The bolus may be repeated<\/p>\n
one time if the patient remains in cardiac arrest. This is followed by 15 mL\/kg\/hr over 30-60 minutes.<\/p>\n
Intralipid<\/p>\n
\u00ae can also be administered peripherally. Potential complications with Intralipid\u00ae are fat embolization,<\/p>\n
interactions with other medications (such as vasopressors) leading to decreased efficacy, and<\/p>\n
allergic reactions (egg-derived). (Maryland Tox Center)<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
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Local Anesthetics Toxicity and Intralipids - Crashing Patient<\/title>\n \n \n \n\t \n\t \n\t \n