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Lipid emulsion therapy

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https://www.readbyqxmd.com/read/28705745/massive-diltiazem-and-metoprolol-overdose-rescued-with-extracorporeal-life-support
#1
James A Chenoweth, Daniel K Colby, Mark E Sutter, Joshua B Radke, Jonathan B Ford, J Nilas Young, John R Richards
The management of overdoses of cardioactive medications in the emergency department can be challenging. The reversal of severe toxicity from one or more types of cardioactive medication may fail maximal medical therapies and require extreme invasive measures such as transvenous cardiac pacing and extracorporeal life support. We present a case of massive diltiazem and metoprolol overdose refractory to maximal medical therapy, including intravenous calcium, glucagon, vasopressors, high dose insulin, and lipid emulsion...
July 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28692439/lipid-emulsion-in-local-anesthetic-toxicity
#2
Martyn Harvey, Grant Cave
PURPOSE OF REVIEW: Enthusiasm for regional anesthesia has been driven by multimodal benefits to patient outcomes. Despite widespread awareness and improved techniques (including the increasing use of ultrasound guidance for block placement), intravascular sequestration and the attendant risk of local anesthetic systemic toxicity (LAST) remains. Intravenous lipid emulsion (ILE) for the treatment of LAST has been endorsed by anesthetic regulatory societies on the basis of animal study and human case report data...
July 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28688059/a-case-of-severe-refractory-hypotension-after-amlodipine-overdose
#3
Melissa Chudow, Kevin Ferguson
Calcium channel blockers (CCBs) are responsible for a substantial portion of the mortality associated with cardiovascular medication overdose cases. Amlodipine, a dihydropyridine CCB, can cause prolonged hypotension in overdose. This report describes a severe amlodipine overdose case that was refractory to multiple therapeutic approaches. A 53-year-old male presented after ingesting eighty 10 mg amlodipine tablets in a suicide attempt. The patient was initially managed with calcium boluses, glucagon, multiple vasoactive agents, lipid emulsion infusions and hyperinsulinemic euglycemic therapy...
July 7, 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#4
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28606477/n-3-polyunsaturated-fatty-acid-enriched-lipid-emulsion-improves-paneth-cell-function-via-the-il-22-stat3-pathway-in-a-mouse-model-of-total-parenteral-nutrition
#5
Jiwei Wang, Feng Tian, Huijun Zheng, Hao Tian, Peng Wang, Li Zhang, Xuejin Gao, Xinying Wang
Total parenteral nutrition (TPN) is a life-saving therapy for patients with gastrointestinal dysfunction or failure. Long-term TPN impairs gut barrier function and contributes to infections and poor clinical outcomes. However, the underlying mechanisms of TPN-related gut barrier damage have not been fully elucidated, and effective measures are still rare. Here, we compared the effects of a predominantly n-6 polyunsaturated fatty acids emulsion (PUFAs; Intralipid) and a lipid emulsion containing n-3 PUFAs (Intralipid plus Omegaven) on antimicrobial peptides produced by Paneth cells...
August 19, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28565972/effects-of-insulin-glucose-pretreatment-on-bupivacaine-cardiotoxicity-in-rats
#6
Ö Pişkin, B G Aydın
A mistaken overdose of bupivacaine into systemic circulation may cause severe cardiovascular side effects. The aim of this study was to assess the effects of pretreatment with combined intra venous lipid emulsion (ILE) and high-dose insulin therapy against cardiotoxicity caused by bupivacaine intoxication. The rats were divided into the following three groups: Group B received a saline pretreatment plus a bupivacaine, group L received ILE pretreatment plus a bupivacaine, and in group I, insulin with glucose was infused intravenously, plus ILE pretreatment plus a bupivacaine...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28562387/lipid-resuscitation-in-acute-poisoning-after-a-decade-of-publications-what-have-we-really-learned
#7
Lotte C G Hoegberg, Sophie Gosselin
PURPOSE OF REVIEW: The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both humans and animals attest to its clinical use, but current supporting evidence is inconsistent. RECENT FINDINGS: A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials, large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28557718/combination-clearance-therapy-and-barbiturate-coma-for-severe-carbamazepine-overdose
#8
Asya Agulnik, Daniel P Kelly, Rebecca Bruccoleri, Christopher Yuskaitis, Darius Ebrahimi-Fakhari, Mustafa Sahin, Michele M Burns, Daniel S Kohane
A 15-year-old female subject presented comatose, in respiratory failure and shock, after the intentional ingestion of ∼280 extended-release 200-mg carbamazepine tablets with a peak serum concentration of 138 µg/mL (583.74 µmol/L). The patient developed clinical seizures and an EEG pattern of stimulus-induced rhythmic, periodic, or ictal discharges, suggestive of significant cortical dysfunction. Due to the extremely high drug serum concentration and clinical instability, a combination of therapies was used, including lipid emulsion therapy, plasmapheresis, hemodialysis, continuous venovenous hemodiafiltration, and endoscopic intestinal decontamination...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28509770/tumescent-anaesthesia-its-applications-and-well-tolerated-use-in-the-out-of-operating-room-setting
#9
Natalie F Holt
PURPOSE OF REVIEW: Tumescent anaesthesia is a method of administering dilute local anaesthetic into the subcutaneous tissue. Many anaesthesiologists are unfamiliar with the technique, its applications and potential risks. RECENT FINDINGS: The maximum safe dose of lidocaine with epinephrine in tumescent anaesthesia for liposuction is probably between 35 and 55 mg/kg. Without liposuction, the maximum dose of lidocaine with epinephrine should be no more than 28 mg/kg...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28489457/adverse-events-associated-with-a-large-dose-of-intravenous-lipid-emulsion-for-suspected-local-anesthetic-toxicity
#10
Daniel J Corwin, Alexis Topjian, Brenda L Banwell, Kevin Osterhoudt
BACKGROUND: Intravenous lipid emulsion (ILE) has gained favor as a rescue treatment for cardiovascular collapse due to intravenous local anesthetic overdose, however, goals of ILE therapy are still being defined. We describe a case of a girl given 66 mL/kg of 20% lipid emulsion (ILE) in the treatment of presumed mepivacaine toxicity. CASE REPORT: An 11-year-old girl weighing 55.6 kg developed pallor, rolling back of the eyes, and rhythmic muscle twitching after receiving a mandibular nerve block injection with a 1...
July 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28437326/favorable-outcomes-of-preterm-infants-with-parenteral-nutrition-associated-liver-disease-treated-with-intravenous-fish-oil-based-lipid-emulsion
#11
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacob, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: The aim of the study was to determine the acute and long-term outcomes of preterm infants treated with an intravenous fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from parenteral nutrition were eligible. Enrolled infants received 1 g · kg · day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
May 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28435264/efficient-co-delivery-of-immiscible-hydrophilic-hydrophobic-chemotherapeutics-by-lipid-emulsions-for-improved-treatment-of-cancer
#12
Bo Zhang, Yunmei Song, Tianqi Wang, Shaomei Yang, Jing Zhang, Yongjun Liu, Na Zhang, Sanjay Garg
Combinational nanomedicine is becoming a topic of much interest in cancer therapy, although its translation into the clinic remains extremely challenging. One of the main obstacles lies in the difficulty to efficiently co-deliver immiscible hydrophilic/hydrophobic drugs into tumor sites. The aim of this study was to develop co-loaded lipid emulsions (LEs) to co-deliver immiscible hydrophilic/hydrophobic drugs to improve cancer therapy and to explore the co-delivery abilities between co-loaded LEs and mixture formulation...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28419458/therapeutic-potential-of-novel-formulated-forms-of-curcumin-in-the-treatment-of-breast-cancer-by-the-targeting-of-cellular-and-physiological-dysregulated-pathways
#13
REVIEW
Amir Tajbakhsh, Malihe Hasanzadeh, Mehdi Rezaee, Mostafa Khedri, Majid Khazaei, Soodabeh ShahidSales, Gordon A Ferns, Seyed Mahdi Hassanian, Amir Avan
Breast cancer is among the most important causes of cancer related death in women. There is a need for novel agents for targeting key signaling pathways to either improve the efficacy of the current therapy, or reduce toxicity. There is some evidence that curcumin may have antitumor activity in breast cancer. Several clinical trials have investigated its activity in patients with breast cancer, including a recent trial in breast cancer patients receiving radiotherapy, in whom it was shown that curcumin reduced the severity of radiation dermatitis, although it is associated with low bioavailability...
April 17, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28393688/nanoscale-functional-biomaterials-for-cancer-theranostics
#14
Linying Liu, Xiaoshuang Li, Lei Chen, Xin Zhang
Nanomedicine is widely developed in recent years. In nanomedicine system, nanoscale and nanostructured functional materials are used to manipulate the human biology systems at the molecular level for cancer imaging and therapy. New nanostructure based functional materials consist of nanoscale liposomes, spheres, micelles, capsules, emulsion, suspension and phamacosomes. Several functional nanoparticles such as lipid-based and polymer-based materials are demonstrated to be drug delivery vehicles and imaging agents...
April 6, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28387487/-how-i-treat-%C3%A2-severe-beta-blocker-poisoning-pharmacological-approaches-and-ecmo
#15
P Horward, B Lambermont, J-O Defraigne, C Gurdebeke, P Morimont
We report the case of a woman with severe beta-blocker poisoning who, after failure of pharmacological therapy, was supported with an ECMO (ExtraCorporeal Membrane Oxygenation) device. We discuss conventional pharmacological treatments and other approaches that have emerged over the past decade such as high dose insulin therapy and lipid emulsions. Major advance has been achieved in the field of ECMO devices and their management. ECMO is now the first line device for refractory acute cardiac and/or pulmonary failure...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28346007/lipid-emulsion-improves-survival-in-animal-models-of-local-anesthetic-toxicity-a-meta-analysis
#16
Michael R Fettiplace, Daniel J McCabe
INTRODUCTION: The Lipid Emulsion Therapy workgroup, organized by the American Academy of Clinical Toxicology, recently conducted a systematic review, which subjectively evaluated lipid emulsion as a treatment for local anesthetic toxicity. We re-extracted data and conducted a meta-analysis of survival in animal models. METHODS: We extracted survival data from 26 publications and conducted a random-effect meta-analysis based on odds ratio weighted by inverse variance...
February 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28293389/exploring-the-effect-of-intravenous-lipid-emulsion-in-acute-methamphetamine-toxicity
#17
Ameneh Ghadiri, Leila Etemad, Mohammad Moshiri, Seyed Adel Moallem, Amir Hossein Jafarian, Farzin Hadizadeh, Mahmoud Seifi
OBJECTIVES: The increasing use of methamphetamine (METH) in the last decades has made it the second most abused drug. Advancs in the area of intravenous lipid emulsion (ILE) have led to its potential application in the treatment of poisoning. The present study aims to investigate the potential role of ILE as an antidote for acute METH poisoning. MATERIALS AND METHODS: Two groups of six male rats were treated by METH (45 mg/kg), intraperitoneally. Five to seven min later, they received an infusion of 18...
February 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28161466/cmrna-lipoplex-encapsulation-in-plga-microspheres-enables-transfection-via-calcium-phosphate-cement-cpc-plga-composites
#18
Maximilian Utzinger, Anita Jarzebinska, Nicolas Haag, Martin Schweizer, Gerhard Winter, Christian Dohmen, Carsten Rudolph, Christian Plank
In this study lipoplexes containing chemically modified messenger RNA (cmRNA) were incorporated into poly (lactic-co-glycolic acid) (PLGA) microspheres via water-in-oil-in-water (W/O/W) double emulsion solvent evaporation technique. The nanoparticle encapsulation by microparticle formation was optimized to achieve lipoplex release and maximum transfection efficiency in surrounding cells. It was possible to adjust characteristic features in surface topology and size of the PLGA-microspheres by varying the extent of lipoplex loading into the polymer matrix...
February 2, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28098869/core%C3%A2-shell-lipid-polymer-nanoparticles-for-combined-chemo%C3%A2-and-gene-therapy-of-childhood-head-and-neck-cancers
#19
Tiesong Zhang, Jing Ma, Chao Li, Ken Lin, Fan Lou, Hongchao Jiang, Yingqin Gao, Yanli Yang, Cheng Ming, Biao Ruan
Pediatric head and neck cancers account for overall 12% of all pediatric cancers. Despite recent advances in therapeutic modalities, children with tumor metastasis have poor prognosis. Therefore, there is an unmet need for new and effective treatment modalities for pediatric head and neck cancers. The present study describes a simple and efficient method for fabrication of cationic lipid‑polymer hybrid nanoparticles (CLPNs) for co‑delivery of cisplatin (CDDP) and DNA (CDDP/DNA CLPNs) for the therapy of childhood head and neck cancers...
March 2017: Oncology Reports
https://www.readbyqxmd.com/read/28012788/lipid-therapy-for-intoxications
#20
REVIEW
Joris Henricus Robben, Marieke Annet Dijkman
This review discusses the use of intravenous lipid emulsion (ILE) in the treatment of intoxications with lipophilic agents in veterinary medicine. Despite growing scientific evidence that ILE has merit in the treatment of certain poisonings, there is still uncertainty on the optimal composition of the lipid emulsion, the dosing, the mechanism of action, and the efficacy. Therefore, a critical view of the clinician on the applicability of this modality in intoxications is still warranted. The use of ILE therapy is advocated as an antidote in cases of intoxications with some lipophilic substances...
December 21, 2016: Veterinary Clinics of North America. Small Animal Practice
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