Pharmacopeia

CWP-0135

Intralipid 20%

Antidotes · Antidotes · Level 3

Legacy Cicm Level

Level 3

Indications Uses

- TPN mixtures
- Local anaesthetic toxicity with or without circulatory arrest
- Prevention of essential fatty acid deficiency syndrome

Chemical Pharmaceutics

fat emulsion

Presentation

white, oil-water emulsion with 20% soybean oil, egg yolk phospholipids, glycerin, sodium hydroxide and water

Main Action

- Energy substrate
- Reverse local anaesthetic cardiotoxicity

Mechanism of action

- unclear
- may involve establishment of concentration gradient away from primary site of action of LA

Onset Peak Duration

(For LA tox)
onset: minutes
peak: 15-30mins

Physiological effects

- energy substrate (essential fatty acids)
- managing lipophilic drug overdose by binding and facilitating clearance

Adverse Effects Toxicity

- Fat embolism
- Hyperlipidemia, pancreatitis
- Hepatic dysfunction
- Allergic reactions

Absorption

IV only

Protein binding

None

Volume of distribution

Wide - distributed to fat and tissues

Metabolism

Liver
Broken down to Fatty acids and glycerol

Excretion

Liver and kidneys

Half-life

not well defined

Special Points

serum amylase or lipase should be monitored for
2 days

Route And Dose

For LA tox: 1.5ml/kg bolus over 1 minute →
Infusion 15 ml/kg/hr

If not stabilized, two subsequent boluses may be given 5 mins apark.
Then rate doubled to 30ml/kg/hr

Max cumulative dose 12ml/kg