Intravenous lipid emulsion for the treatment of drug toxicity

J Intensive Care Med. 2014 Mar-Apr;29(2):59-70. doi: 10.1177/0885066612445978. Epub 2012 Jun 24.

Abstract

Intravenous lipid emulsion (ILE) has emerged as a powerful antidote for the treatment of drug toxicity in the past decade. Initial efficacy of ILE was shown in the setting of local anesthetic systemic toxicity (LAST), but recent case reports suggest its consideration in a variety of other drug toxicities. In this review, we will summarize the experimental evidence as well as the clinical experience in using ILE as an antidote. Specifically, we will look at the evidence for using ILE in LAST as well as toxicity due to beta-blockers, calcium-channel blockers, and tricyclic antidepressants. We will also review the current dosing recommendations as well as potential side effects of ILE as an antidote.

Keywords: intralipid; lipid emulsion; resuscitation; toxicity.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / poisoning
  • Adult
  • Anesthesiology / standards
  • Anesthetics, Local / adverse effects
  • Anesthetics, Local / poisoning
  • Animals
  • Antidepressive Agents, Tricyclic / poisoning
  • Antidotes / standards
  • Antidotes / therapeutic use
  • Calcium Channel Blockers / poisoning
  • Cardiotoxins / poisoning*
  • Dose-Response Relationship, Drug
  • Drug Overdose / therapy*
  • Drug-Related Side Effects and Adverse Reactions / therapy*
  • Fat Emulsions, Intravenous / administration & dosage
  • Fat Emulsions, Intravenous / therapeutic use*
  • Female
  • Heart Arrest / chemically induced*
  • Heart Arrest / drug therapy
  • Humans
  • Male
  • Propranolol / poisoning
  • Treatment Outcome

Substances

  • Adrenergic beta-Antagonists
  • Anesthetics, Local
  • Antidepressive Agents, Tricyclic
  • Antidotes
  • Calcium Channel Blockers
  • Cardiotoxins
  • Fat Emulsions, Intravenous
  • Propranolol