Intravenous Lipid Emulsion for the Treatment of Drug Toxicity

• Published in: Journal of intensive care medicine Vol. 29; no. 2; pp. 59 - 70
• Main Authors: Ozcan, Mehmet S., Weinberg, Guy
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-03-2014
• Subjects: 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; toxicity; lipid emulsion; resuscitation; intralipid
• ISSN: 0885-0666; 1525-1489
• DOI: 10.1177/0885066612445978

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.