Effect of intralipid administration on calcium therapy in verapamil toxicity

Abstract

Aim: Lipid emulsions are promising with regard to the treatment of toxicity by agents of high lipophilic nature. Our objective is to investigate the effi cacy of intralipid 20% and calcium administration at different times when symptoms of cardiac toxicity occur during verapamil infusion. Method: 24 adult male Spraque-Dawley rats were randomly divided into 4 different groups, the control group, calcium group, calcium following 20% intralipid group and concomitant 20% intralipid and calcium group. Following monitoring under ketamine anesthesia, all groups were administered 37.5 mg kg-1 h-1 verapamil infusion until a 50% decrease occurred in MAP b. At the end of the infusion, verapamil infusion was decreased down to 15 mg kg-1 h-1 and the treatment agents predetermined for the groups were administered concomitantly. Results: There is no statistically signifi cant difference between the administration of 20% intralipid synchronized with calcium or as a pretreatment, but both groups provided a higher survival rate when compared to the other groups. Conclusions:The administration of calcium alone in verapamil toxicity is not suffi cient; when calcium and 20% intralipid are administered together, there is no difference between the administration of lipid and calcium concomitantly and the administration of lipid prior to calcium (Tab. 1, Fig. 2, Ref. 23). Text in PDF www.elis.sk.

Calcium dosage in the lipid emulsion used to treat verapamil toxicity

“…A previous study used 15 mg kg -1 calcium chloride (equivalent to approximately 5.45 mg kg -1 calcium) in a lipid emulsion treatment for verapamil toxicity (3). Thus, the calcium dosage used in this study is approximately 55-folds lower than that in the previous study (1,3). Second, it is unclear what type of solution (intralipid or normal saline) was used to dissolve calcium (0.2 mmol kg -1 ) in the group administered with loading dose intralipid followed by calcium (Group L-Ca) (1).…”

“…We have read the interesting report titled "Effect of intralipid administration on calcium therapy in verapamil toxicity," recently published in Bratislava Medical Journal (1). Lipid emulsions can effectively attenuate severe vasodilation induced by toxic doses of the highly lipid soluble calcium channel blocker, verapamil (2).…”

Kali̇teli̇ Embri̇yo Transferi̇ne Rağmen Başarisiz Ivf Si̇klusu Olan Kadinlarda i̇n Vi̇tro Ferti̇li̇zasyon (Ivf) Tedavi̇si̇ Boyunca İv Li̇pi̇d (Smoflipid®) Kullaniminin Etki̇si̇: Vaka Kontrol Çalişmasi

“…[8][9] A large evidence revealed that intravenous lipid has positive effect on the treatment of some medical problems such as verapamil toxicity, malathion-induced hepatotoxicity and chronic intestinal failure. [10][11] In the literature, there are few solid data about using intravenous lipid as a feasible, safe, cost-effective agent in the treatment of RIF patients. [12][13] In this study, it was aimed to investigate the effect of intravenous lipid on outcomes measured in terms of implantation rate and pregnancy rate in patients with unexplained RIF undergoing IVF/ICSI.…”