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Literature review of the evidence regarding intravenous lipid administration in drug-induced cardiotoxicity.

Abstract
Introduction: Intravenous lipid emulsion (ILE) administration is capable of reversing the acute cardiac and neurological toxicity caused by local anesthetic agents. In recent years, ILE has also been explored as a potential antidote for cardiotoxicity caused by non-anesthetic agents too. Areas covered: The potential mechanisms, safety, and efficacy of this approach are considered. Data were sought from published reports listed in PubMed and EMBASE, and abstracts of meetings of the North American Congress of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists. There were reports involving 298 patients where ILE has been administered for severe drug toxicity. Clinical improvement was observed in 57 of 59 patients with local anesthetic toxicity (96.6%); there were 239 patients where toxicity was due to non-anesthetic agents, and ILE apparently improved clinical outcome in 215 (72.1%). Expert opinion: Response rates were similar between ILE treated toxicity caused by lipid soluble and non-lipid soluble drugs. Potential adverse effects of ILE include interference with laboratory assays, acute pancreatitis, and adult respiratory distress syndrome, although the rate of occurrence is difficult to ascertain.
AuthorsMaria Paneta, William Stephen Waring
JournalExpert review of clinical pharmacology (Expert Rev Clin Pharmacol) Vol. 12 Issue 7 Pg. 591-602 (Jul 2019) ISSN: 1751-2441 [Electronic] England
PMID31106655 (Publication Type: Journal Article, Review)
Chemical References
  • Anesthetics, Local
  • Antidotes
  • Fat Emulsions, Intravenous
Topics
  • Anesthetics, Local (administration & dosage, adverse effects)
  • Animals
  • Antidotes (administration & dosage, adverse effects)
  • Cardiotoxicity (etiology, therapy)
  • Drug-Related Side Effects and Adverse Reactions (physiopathology, therapy)
  • Fat Emulsions, Intravenous (administration & dosage, adverse effects)
  • Humans

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