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Intralipid
From WikEM
Contents
General
- Type: Lipid emulsion
- Dosage Forms: 20% fat emulsion
- Routes of Administration: IV
- Common Trade Names: Intralipid
- Emergency department indications: Local anesthetic systemic toxicity, refractory hemodynamic instability secondary to ingestion of cardiodepressive medications / toxins (i.e. Beta blocker or Calcium Channel Blocker)
Adult Dosing
- 1.5 ml/kg bolus[1]
- Followed by 0.25 ml/kg/min for 20 min or until hemodynamic stability is achieved.[2]
Pediatric Dosing
Special Populations
- Pregnancy Rating: C
- Lactation risk:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Asystole (case reported) [3]
- Fat embolism
- Hypersensitivity reactions
Common
- Pancreatitis[4]
- Hypertriglyceridemia[4]
- Interferes with some lab measurements
- Glucose and magnesium concentrations become inaccurate
- Creatinine and lipase become unmeasurable
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
- Emulsion acts as a “lipid sink,” surrounding a lipophilic drug molecule and rendering it ineffective
- Fatty acids from the ILE provide the myocardium with a ready energy source, improving cardiac function
Comments
See Also
External Links
References
- ↑ Cave, G. Intravenous Lipid Emulsion as Antidote Beyond Local Anesthetic Toxicity: A Systematic Review. 2009. 16(9)815–824
- ↑ Dillane D, Finucane BT. Local anesthetic systemic toxicity. Can J Anaesth. 2010 Apr;57(4):368-80.
- ↑ Cole JB et al. Asystole immediately following intravenous fat emulsion for overdose. J Med Toxicol. 2014;10(3)307-310
- ↑ 4.0 4.1 Kostic MA and Gorelick M. Review of the use of lipid emulsion in nonlocal anesthetic poisoning. Pediatric Emergency Care 2014;30:427-436
