Prolonged Use of Intravenous Lipid Emulsion in a Severe Tricyclic Antidepressant Overdose
Journal of Medical ToxicologyPublished 31 October 2013Open access
Ravi Agarwala, Syed Z. Ahmed, Timothy J. Wiegand
Citations58
SJR quartileQ2
SJR score0.93
SNIP1.36
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A low-dose infusion of ILE was well tolerated and may have successfully prevented recurrent toxicity in a case of severe tricyclic antidepressant overdose, which is now frequently being used for severe overdoses due to lipophilic drugs.
Abstract
A low-dose infusion of ILE was well tolerated and may have successfully prevented recurrent toxicity in a case of severe tricyclic antidepressant overdose.
Keywords
Medicine
AnesthesiologyLipid Emulsion Infusion
321 Citations2012Guy Weinberg, Bruno Riou
This review will focus on the clinical application of lipid emulsion therapy in resuscitation from drug-related toxicity and provide an introduction to the development of the method, guidelines for its use and insights into potential controversies and future applications.
Clinical ToxicologyLipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies
221 Citations2010Chloé Jamaty, Benoît Bailey +4 more
The quality of evidence was weak and significant heterogeneity prevented data pooling, and available data suggest some benefits of IFE in bupivacaine, verapamil, chlorpromazine, and some tricyclic antidepressants and beta-blockers toxicity.
Scandinavian Journal of Trauma Resuscitation and Emergency MedicineIntravenous lipid emulsion in clinical toxicology
185 Citations2010Leelach Rothschild, Sarah Bern +2 more
Current case reports of successful resuscitation suggest the efficacy of lipid emulsion infusion for treating non-local anesthetic overdoses across a wide spectrum of drugs: beta blockers, calcium channel blockers, parasiticides, herbicides and several varieties of psychotropic agents.
Journal of Medical ToxicologyACMT Position Statement: Interim Guidance for the Use of Lipid Resuscitation Therapy
89 Citations2011
If LRT is used, it should be instituted for patients with hemodynamic, or other instability, not responsive to standard resuscitation measures, where appropriate, and the decision to use LRT instead of, or in conjunction with, other therapies, such as euglycemic insulin therapy, is to be based on the clinical judgment of the treating physician.
Journal of Medical ToxicologyIntravenous fat emulsion: A potential novel antidote
87 Citations2008Danielle Turner‐Lawrence, William Kerns
The potential role of IFE in treatment of toxicity due to local anesthetics and other lipid-soluble drugs, including lipophilic central nervous and cardiovascular drug toxicity, is reviewed.
Journal of Toxicology Clinical ToxicologyA Meta‐Analysis of Prognostic Indicators to Predict Seizures, Arrhythmias or Death After Tricyclic Antidepressant Overdose
59 Citations2004Benoît Bailey, Nicholas A. Buckley +1 more
Overall, the studies suggested that the ECG and TCA concentration have similar but relatively poor performance for predicting complications, such as seizures, VA or death, associated with TCA overdose.
International Journal of Emergency MedicineCase report: successful lipid resuscitation in multi-drug overdose with predominant tricyclic antidepressant toxidrome
59 Citations2012Martyn Harvey, Grant Cave
Assayed blood levels were consistent with the 'lipid sink' being a major effecter in the observed improvement, thereby curtailing the need for ongoing vasopressor medications.
Journal of Medical ToxicologyClinical Experience with Intravenous Lipid Emulsion for Drug-Induced Cardiovascular Collapse
56 Citations2011Ann-Jeannette Geib, Erica L. Liebelt +1 more
ILE administered to patients with drug-induced cardiovascular collapse was associated with 55% survival but with clinically significant adverse effects, and ILE should be restricted to cardiotoxicity involving cardiac arrest or refractory shock until further prospective studies can better evaluate risks and benefits of ILE therapy.
ResuscitationIntravenous fat emulsion to reverse haemodynamic instability from intentional amitriptyline overdose
47 Citations2010Paul T. Engels, Jonathan Davidow
The first case of amitriptyline toxicity treated with intravenous fat emulsion (IFE) is reported, manifested as vasopressor-refractory haemodynamic instability despite standard therapy.
Basic & Clinical Pharmacology & ToxicologyNo Antidotal Effect of Intravenous Lipid Emulsion in Experimental Amitriptyline Intoxication Despite Significant Entrapment of Amitriptyline
33 Citations2011Erik Litonius, Tomohisa Niiya +2 more
A marked entrapment of amitriptyline by intravenous lipid emulsion was observed but this did not improve the pigs' haemodynamic recovery from severe amitripyline intoxication, and care should be exercised in the antidotal use of lipidEmulsion until controlled human studies indicate its efficacy and safety.
Clinical ToxicologyAbstracts of the XXIX International Congress of the European Association of Poison Centres and Clinical Toxicologists, May 12–15, 2009, Stockholm, Sweden
12 Citations2009Wood, K. L., Thompson, John Paul
