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Journal ArticleDOI

Lipid infusion in the management of poisoning: a report of 6 canine cases.

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TLDR
Six cases of poisoning in dogs successfully treated with lipid infusion after ingestion of ivermectin, moxidectin and baclofen are presented and none developed any apparent sequelae.
Abstract
Intravenous administration of lipid is a relatively new treatment in the management of toxicity from lipophilic compounds. It is used in human medicine in the treatment of toxicity from lipophilic local anaesthetics and cardiotoxic drugs and can result in dramatic improvement in clinical status. We present six cases of poisoning in dogs successfully treated with lipid infusion after ingestion of ivermectin (3), moxidectin (2) and baclofen (1). The dogs ranged in age from eight weeks to 14 years, and weighed 4–30 kg. Intravenous lipid therapy was started between six and eight hours and 22 hours after ingestion, and all the dogs responded well. In four dogs, there was clinical improvement within one hour; one had improved within two hours and the other within 4.5 hours of lipid administration. The only adverse effect of lipid infusion reported was mild swelling and pain after extravasation in one case which resolved with conservative management. All the dogs were discharged within 24–52 hours after exposure (7–46 hours after the start of lipid administration), and none developed any apparent sequelae.

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Citations
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Perspectives on the utility of moxidectin for the control of parasitic nematodes in the face of developing anthelmintic resistance.

TL;DR: There are reasonable prospects that strains of parasites that are resistant to avermectins at currently recommended doses will be controlled by MOX if it can be administered at sufficiently high doses and in formulations that enhance its persistence in the host.
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Resuscitation with Lipid Emulsion: Dose-dependent Recovery from Cardiac Pharmacotoxicity Requires a Cardiotonic Effect

TL;DR: Intravenous lipid emulsion accelerates cardiovascular recovery from bupivacaine toxicity in a dose-dependent manner, which is driven by a cardiotonic response that complements the previously reported sequestration effect.
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Past, Present, and Future of Lipid Resuscitation Therapy:

TL;DR: The past, present, and future of lipid resuscitation therapy is discussed with a focus on the understanding of the mechanism and directions that the field is moving, both from a clinical and basic research side.
References
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Journal ArticleDOI

Lipid emulsion infusion: resuscitation for local anesthetic and other drug overdose.

TL;DR: This review will focus on the clinical application of lipid emulsion therapy in resuscitation from drug-related toxicity and provide an introduction to the development of the method, guidelines for its use and insights into potential controversies and future applications.
Journal ArticleDOI

Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies

TL;DR: The quality of evidence was weak and significant heterogeneity prevented data pooling, and available data suggest some benefits of IFE in bupivacaine, verapamil, chlorpromazine, and some tricyclic antidepressants and beta-blockers toxicity.
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Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review.

TL;DR: Management of overdose with highly lipophilic cardiotoxic medications should proceed in accord with established antidotal guidelines and early poisons center consultation, and suggestive that ILE may be helpful in potentially lethal cardiotoxicity or developed cardiac arrest attributable to such agents.
Journal ArticleDOI

Recurrence of Cardiotoxicity After Lipid Rescue from Bupivacaine-Induced Cardiac Arrest

TL;DR: This case suggests that local anesthetic systemic toxicity may recur after initial lipid rescue, and since recurrence of toxicity may necessitate administration of additional doses of lipid emulsion, a sufficient quantity of cholesterol emulsion should be available when regional anesthesia is performed.
Journal ArticleDOI

Ivermectin: does P-glycoprotein play a role in neurotoxicity?

TL;DR: P-glycoprotein is an integral component of the human blood brain barrier and plays a central role in limiting drug uptake into the brain, resulting in reduced extracellular efflux and enhanced CNS toxicity.
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