08 Feb 09

Lipid emulsion to treat drug overdose: past, present and future

Posted in Drug overdose at 12:43 by Laci

By J Picard and W Harrop-Griffiths

Anaesthesia 2009;64:119-121

A week may be a long time in politics, but in medicine changes are generally much slower. However, in at least one respect, much has changed in British anaesthesia in less than 3 years.

An editorial published in this journal in February 2006 considered the use of intravenous lipid emulsion to treat overwhelming overdoses of local anaesthetic drugs [1]. The editorialists outlined the persuasive evidence from experiments on animals, and argued that local anaesthetic intoxication is so very rare, so catastrophic and so unpredictable that ethically acceptable, controlled human trials are, and always will be, impossible. Their conclusion was that, if a patient was in refractory cardiac arrest attributable to local anaesthetic intoxication, there would be little to lose from giving intravenous lipid, and potentially everything to gain.

Early treatment of a quetiapine and sertraline overdose with Intralipid®

Posted in Drug overdose at 12:40 by Laci

By S D H Finn, D R Uncles, J Willers and N Sable

Anaesthesia 2009;64:191-194

We describe the initial management and subsequent recovery of a 61 year-old male patient following attempted suicide by oral ingestion of a potentially fatal overdose of quetiapine and sertraline. Intravenous Intralipid® was given soon after initiation of basic resuscitation. There was a rapid improvement in the patient’s level of consciousness. No other clinical signs of drug toxicity were observed. Intralipid may have reversed the deep coma associated with ingestion and prevented other manifestations of drug toxicity occurring, thus expediting this patient’s recovery.

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