Friday, December 6, 2019


Q: What are the three mechanisms by which Intravenous Lipid Emulsion (ILE) Therapy works in toxicology?

Answer: The first question is to determine that if ingested drug/toxin molecule is lipophilic or not? If the answer is yes than ILE works via three mechanisms:

1. Lipid emulsion acts as a "lipid sink". It surrounds a lipophilic drug molecule making it ineffective.

2. The second and less well-known action is via the fatty acids present in ILE. It provides the myocardium with an extra energy source, enhancing its contractility leading to improved hemodynamics.

3. ILE works as a "lipid shuttle". It encapsulates the toxin and transports to the liver and kidney for metabolism.



1. Gueret G, Pennec JP, Arvieux CC. Hemodynamic effects of intralipid after verapamil intoxication may be due to a direct effect of fatty acids on myocardial calcium channels. Acad Emerg Med 2007; 14:761.

2. Gosselin S, Hoegberg LC, Hoffman RS, et al. Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning(). Clin Toxicol (Phila) 2016; 54:899.

3. Jamaty C, Bailey B, Larocque A, et al. Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol (Phila) 2010; 48:1. 

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