Lipid emulsion facilitates reversal from volatile anesthetics in a rodent model

Effect of lipid emulsion on neuropsychiatric drug-induced toxicity: A narrative review

“…[ 71 , 72 ] An animal study also corroborated that lipid emulsion shortened the time from isoflurane anesthesia to recovery, and decreased the proportion of the delta-band in the electroencephalogram during anesthesia, which appears to be mediated by lipid emulsion-induced reduction of isoflurane concentrations. [ 9 ] Lipid emulsion and supportive treatment improved the GCS of patients with drug toxicity due to nonlocal anesthetic drugs or clozapine alone. [ 7 , 8 ] Consistent with previous reports, [ 7 , 8 , 72 ] in our analysis, lipid emulsion reversed the decreased GCS score related to overdoses of the following: amitriptyline (log P : 4.92), trazodone (log P : 2.68), quetiapine (log P : 2.81), citalopram (log P : 3.76), bromazepam (log P : 2.05), fluoxetine (log P : 4.05), alprazolam (log P : 2.12), lamotrigine (log P : 2.57), and sertraline (log P : 5.51), which are all highly-soluble (log P : 3.38 ± 1.24).…”

“…[ 73 ] Thus, considering these previous laboratory reports, the increase in GCS after lipid emulsion administration may be associated with increased partitioning of highly lipid-soluble neuropsychiatric drugs into the blood from the brain. [ 9 , 73 ] However, further studies are needed to examine the detailed mechanism responsible for this phenomenon.…”

“…[8] In addition, the time required to recovery from sevoflurane and isoflurane anesthesia was shortened by lipid emulsion in rats, and appeared to be mediated by lipid emulsion-mediated reduction of sevoflurane and isoflurane concentrations. [9] However, a systemic analysis of case reports regarding the effect of lipid Hwang and Sohn • Medicine (2024) 103: 11 Medicine emulsion on neuropsychiatric drug-induced toxicity, including antidepressants, antipsychotics, benzodiazepines (sedatives), and anticonvulsants, has not previously been reported. Moreover, a randomized controlled study regarding the effect of lipid emulsion on neuropsychiatric drug-induced toxicity in humans is impossible due to ethics concerns.…”

Biomedical Nanosystems for <i>in vivo</i> Detoxification: From Passive Delivery Systems to Functional Nanodevices and Nanorobots

“…Lipid emulsion resuscitation therapy is recommended for the treatment of lipophilic drug overdoses; specifically, lipid emulsions (LE) are administered intravenously as non-specific antidotes, in the form of an "oil-in-water" type of drops [ 35 ]. LEs have been used for overdose treatment and to reduce the concentration of lipophilic antiarrhythmic, psychotropic, antimalarial drugs, local anesthetics, calcium channel blockers such as propranolol [ 36 ], cocaine [ 37 , 38 ], diltiazem [ 39 ], buprenorphine, fentanyl and butorphanol [ 40 ], bupivacaine [ 41 ], ivermectin [ 42 , 43 ], and ropivacaine [ 44 , 45 ]. LEs rapidly decrease the threshold for seizure activity, amoxapine toxicity [ 46 ], and improve cardiac activity during heart transplantation [ 47 ].…”

“…Известно, что при передозировке липофильных препаратов рекомендуется применение липидной реанимационной терапии, а именно, использование в качестве неспецифических антидотов липидных эмульсий (ЛЭ) -внутривенно вводимых наноразмерных капель типа «масло в воде» [35]. ЛЭ применяют при передозировке и для снижения концентрации липофильных антиаритмических, психотропных, противомалярийных препаратов, местных анестетиков, блокаторов кальциевых каналов, таких, как пропранолол [36], кокаин [37,38], дилтиазем [39], бупренорфин, фентанил и буторфанол [40], бупивакаин [41], ивермектин [42,43], ропивакаин [44,45]. Использование ЛЭ быстро снижает порог судорожной активности, токсичности амоксапина [46], улучшает сердечную деятельность при трансплантации сердца [47].…”