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Self-Nanoemulsification of Healthy Oils to Enhance the Solubility of Lipophilic Drugs
Published on: July 27, 2022
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Lipid emulsion for xenobiotic overdose: PRO.
Michael R Fettiplace1, Guy Weinberg2
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
British Journal of Clinical Pharmacology
|December 1, 2022
Summary
Lipid emulsion infusion effectively treats local anesthetic systemic toxicity (LAST) and other drug overdoses. Evidence supports its use, potentially reducing the need for advanced life support like cardiopulmonary bypass.
Area of Science:
- Toxicology
- Pharmacology
- Emergency Medicine
Background:
- Lipid emulsion infusion originated as a treatment for local anesthetic systemic toxicity (LAST).
- Its use expanded to non-anesthetic overdoses without formal clinical trials.
- Recent trials show efficacy in various poisonings.
Purpose of the Study:
- To review preclinical evidence for lipid emulsion in toxicity.
- To evaluate recent clinical studies on lipid emulsion for drug overdoses.
- To explore dose-response relationships and study limitations.
Main Methods:
- Review of pre-clinical data supporting lipid emulsion use.
- Analysis of recent clinical trials and case reports on lipid emulsion therapy.
- Evaluation of analytical tools supporting efficacy in LAST.
Main Results:
- Lipid emulsion has demonstrated efficacy in treating LAST and overdoses of antipsychotics, pesticides, metoprolol, and tramadol.
- Clinical data suggests lipid emulsion can obviate the need for cardiopulmonary bypass in LAST.
- A potential dose-dependent requirement for efficacy is identified.
Conclusions:
- Lipid emulsion is a valuable treatment for various drug toxicities, including LAST.
- Further research, potentially using alternative analytical methods, is needed due to the difficulty of conducting formal trials for LAST.
- Understanding dose requirements is crucial for optimizing lipid emulsion therapy.
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