Which administered antidote causes this appearance in a blood sample?
a) Hydroxocobalamin
b) Intravenous Lipid Emulsion (ILE)
c) Methylene blue
d) N-acetylcysteine
This post was peer reviewed on behalf of ACMT by Bryan Judge, Louise Kao, and Diane Calello.
References
- Weinberg GL, VadeBoncouer T, Ramaraju GA, Garcia-Amaro MF, Cwik MJ.Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology. 1998 Apr;88(4):1071-5. PMID: 9579517
- Weinberg G, Ripper R, Feinstein DL, Hoffman W. Lipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity. Reg Anesth Pain Med. 2003 May-Jun;28(3):198-202. PMID: 12772136
- Weinberg GL. Lipid emulsion infusion: resuscitation for local anesthetic and other drug overdose. Anesthesiology. 2012 Jul;117(1):180-7. PMID: 22627464; PMID: 4609208
- Shi K, Xia Y, Wang Q, Wu Y, Dong X, Chen C, Tang W, Zhang Y, Luo M, Wang X, Papadimos TJ, Xu X. The effect of lipid emulsion on pharmacokinetics and tissue distribution of bupivacaine in rats. Anesth Analg. 2013 Apr;116(4):804-9. PMID: 23460566
- Fettiplace MR, McCabe DJ. Lipid emulsion improves survival in animal models of local anesthetic toxicity: a meta-analysis. Clin Toxicol (Phila). 2017 Aug;55(7):617-623. doi: 10.1080/15563650.2017.1288911. Epub 2017 Feb 17. Review. PMID: 28346007
- Gosselin S, Hoegberg LC, Hoffman RS, Graudins A, Stork CM, Thomas SH, Stellpflug SJ, Hayes BD, Levine M, Morris M, Nesbitt-Miller A, Turgeon AF, Bailey B, Calello DP, Chuang R, Bania TC, Mégarbane B, Bhalla A, Lavergne V. Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning(). Clin Toxicol (Phila). 2016 Dec;54(10):899-923. doi:10.1080/15563650.2016.1214275. Epub 2016 Sep 8. Review. PMID: 27608281
- Food and Drug Administration. Intralipid® 20% https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017643s072,018449s039lbl.pdf. Date Accessed: 06/21/2019.
- American College of Medical Toxicology. ACMT Position Statement: Guidance for the Use of Intravenous Lipid Emulsion. J Med Toxicol. 2017 Mar;13(1):124-125. doi: 10.1007/s13181-016-0550-z. Epub 2016 Apr 27. Erratum in: J Med Toxicol. 2016 Dec;12 (4):416. PMID: 27121236. PMID: 5330953
- Grunbaum AM, Gilfix BM, Hoffman RS, Lavergne V, Morris M, Miller-Nesbitt A, Gosselin S. Review of the effect of intravenous lipid emulsion on laboratory analyses. Clin Toxicol (Phila). 2016;54(2):92-102. doi:10.3109/15563650.2015.1115515. Epub 2015 Dec 1. Review. PMID: 26623668
- Hayes BD, Gosselin S, Calello DP, Nacca N, Rollins CJ, Abourbih D, Morris M, Nesbitt-Miller A, Morais JA, Lavergne V; Lipid Emulsion Workgroup. Systematic review of clinical adverse events reported after acute intravenous lipid emulsion administration. Clin Toxicol (Phila). 2016 Jun;54(5):365-404. PMID: 27035513
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