Les émulsions lipidiques dans le traitement des effets cardiotoxiques des médicaments lipophiles autres que les anesthésiques locaux:Antidote ou traitement d'exception?
(2011) Annales françaises de médecine d’urgence — Vol. 1, n° 1, p. 26-32 (2011)
Files
pdfdocument.pdf
Restricted Access - Adobe PDF
- 111.08 KB
Details
- Authors
- Abstract
- While there is an increasing number of both experimental and clinical data supporting the early use of lipid emulsion for the resuscitation of cardiotoxic effects induced by accidental exposure to toxic doses of local anesthetics, data regarding other lipophilic drugs (including some betablockers or calcium-channel antagonists) are scarce. The mechanisms of action of lipid emulsion remain largely debated: lipid sink with sequestration of lipophilic molecules, action on myocardial metabolism, action on ion channels, etc. Experimental data suggest that intravenous lipid emulsion may be helpful in potentially lethal cardiotoxicity due to lipophilic medications, but the experimental conditions appear different from the commonly encountered clinical scenarios of overdose by oral route. No comparison is possible with established antidotal therapies. A limited number of clinical observations reports the successful resuscitation with intravenous lipid emulsion of severe poisonings due to cardiotoxic drugs, after the failure of conventional pharmacological therapy. The dose and duration of lipid emulsion therapy are empirical. Currently, lipid emulsion therapy does not fulfill entirely the criteria for antidotal therapy. Its firstline use, beyond local anesthetic toxicity, cannot be recommended, as more prospective data are required regarding efficacy and safety. © 2011 Société française de médecine d'urgence and Springer-Verlag France.
- Affiliations
Citations
De Roock, S., & Hantson, P. (2011). Les émulsions lipidiques dans le traitement des effets cardiotoxiques des médicaments lipophiles autres que les anesthésiques locaux:Antidote ou traitement d’exception? Annales françaises de médecine d’urgence, 1(1), 26-32. https://doi.org/10.1007/s13341-010-0004-3 (Original work published 2011)