intralipid effective in treating severe cardiotoxicity in local anaesthetic overdose

[Nagelfar]

Worried about cocaine intravenous toxicity due to its sodium channel blockage effects? There's a new way to nullify it for harm reduction! (IV coke users heed well!!)

Apparently, this was discovered when local anesthetics were *accidently* administered IV and resulted in deaths, namely with Bupivacaine which is safe to muscle, but can be fatal when IV'd and mistakes of it being administered in the epidural when there is confusion of the route to be administered by health care workers. Well the following has been discovered to be able to reverse it as a *secondary treatment" e.g. after local anesthetic in question has been (mistakenly) administered intravenously(!)

Lipid emulsion to treat overdose of local anaesthetic

Wikipedia topic on intralipid rescue

And best of all(!!!!!!!!!!!!!!) The design of a 'homemade' lipid rescue kit has been described

I totally want to get back into shooting coke, after I get some of the above and keep it on hand, do coke shot, then following it up with an intralipid shot to survive, bring huge coke shots to a whole new level. This is the narcan of cocaine! (only, it doesn't reverse the subjective effects of the "high", only the deadly ones) imagine being able to do cocaine shots as big as methampetamine shots with no worries? Possibility? Maybe!

 

[sekio]

Somehow i don't think this gives you carte blanche to just go nuts with IV cocaine. It won't save you from a cardiac infarct.

 

[Limpet_Chicken]

Doesn't intralipid have its own risks such as hypersensivity reactions and potential anaphylaxis. I know there have been issues with Cremophor EL. And isn't intralipid vehicle generally used in single shots or a few individual injections if repeat administration of for example, diazepam in cases of an epileptic patient gone into status, rather than as an infusion or repetitive shots (such as are more than likely the case when someone's slamming coke?)

 

[Nagelfar]

And isn't intralipid vehicle generally used in single shots or a few individual injections if repeat administration of for example, diazepam in cases of an epileptic patient gone into status, rather than as an infusion or repetitive shots (such as are more than likely the case when someone's slamming coke?)

Answer is simple: one shot interlipid + multiple shots coke. ;-P

 

[Nagelfar]

Somehow i don't think this gives you carte blanche to just go nuts with IV cocaine. It won't save you from a cardiac infarct.

Maybe not, but definite harm reduction for a very dangerous and widely prevalent drug practice for a route that had no previously known method of HR? Yes.

 

[Limpet_Chicken]

Well can't IV lipid formulations sometimes cause acute allergic reactions?

 

[Skorpio]

The mechanism for intralipid rescue is that it pulls the drug out of circulation. This couldn't be a prophylactic as it would prevent your desired effects. In a hospital it could have some merit in an acute overdose but it would probably be a detriment as it would complicate administration of more important drugs during overdose treatment.

 

[Limpet_Chicken]

So its more a general principle then? how does it differ with respect of response exhibited to given doses (by weight) of hydrophilic vs hydrophobic drugs?

And IIRC some sigma antagonists prevent the seizures associated with overdosing on charlie.

 

[serotonin2A]

So its more a general principle then? how does it differ with respect of response exhibited to given doses (by weight) of hydrophilic vs hydrophobic drugs?

And IIRC some sigma antagonists prevent the seizures associated with overdosing on charlie.

That is true -- it is a mistake to treat cocaine as just another local anesthetic. Factors other than Na channel blockade may also contribute to cocaine toxicity.

It is probably a reasonable assumption to think that lipid rescue would be useful in cocaine overdose. However, the downside is that this treatment should not be performed outside of a medical setting. The lipids can potentially produce dangerous side effects and are always administered in combination with other interventions.

 

[Nagelfar]

It is probably a reasonable assumption to think that lipid rescue would be useful in cocaine overdose. However, the downside is that this treatment should not be performed outside of a medical setting. The lipids can potentially produce dangerous side effects and are always administered in combination with other interventions.

Such amendments are said about any unusual thing going into the body, even calorie dense foods (2,000 cal. liquid replacements: "not to be used without doctor supervision": and I've drank ten of those in a row; twenty thousand calories plus in a few hours, didn't get so much as a stomach ache; not that this topic is in any way comparable to that) but I mention this not to circumvent your harm reduction message. The home intralipid rescue kit I presume was put together by those with the knowledge and the vision to make it safely used by those who had no prior training to be able to use it safely with what is included solely in the kit as indicated on its page. Just see the page linked in the original post at bottom.

 

[serotonin2A]

Such amendments are said about any unusual thing going into the body, even calorie dense foods (2,000 cal. liquid replacements: "not to be used without doctor supervision": and I've drank ten of those in a row; twenty thousand calories plus in a few hours, didn't get so much as a stomach ache; not that this topic is in any way comparable to that) but I mention this not to circumvent your harm reduction message. The home intralipid rescue kit I presume was put together by those with the knowledge and the vision to make it safely used by those who had no prior training to be able to use it safely with what is included solely in the kit as indicated on its page. Just see the page linked in the original post at bottom.

The kit you are describing was not put together for home use -- it is supposed to be used by a physician in an ER. The doctor who developed lipid rescue would be horrified to learn that someone plans to use it at home. The technique requires continuous infusion with saline through a central line, intensive monitoring of vital signs, and administration of other medications and supportive therapy -- things that most people are unable to do. All you are going to do by trying this at home is delay proper medical care.

TL/DR "homemade" does not mean the same thing as "home use"

 

[Nagelfar]

The kit you are describing was not put together for home use -- it is supposed to be used by a physician in an ER. The doctor who developed lipid rescue would be horrified to learn that someone plans to use it at home. The technique requires continuous infusion with saline through a central line, intensive monitoring of vital signs, and administration of other medications and supportive therapy -- things that most people are unable to do. All you are going to do by trying this at home is delay proper medical care.

TL/DR "homemade" does not mean the same thing as "home use"

So like a lemon-aid stand that I let my children start: I can make it at home, but then sell it to people walking by on the street?

 

[hotgirls.jpg.exe]

The kit you are describing was not put together for home use -- it is supposed to be used by a physician in an ER. The doctor who developed lipid rescue would be horrified to learn that someone plans to use it at home. The technique requires continuous infusion with saline through a central line, intensive monitoring of vital signs, and administration of other medications and supportive therapy -- things that most people are unable to do. All you are going to do by trying this at home is delay proper medical care.

TL/DR "homemade" does not mean the same thing as "home use"

Quoting this again because you seem to not be getting it. Go ahead and email the creator of the kit and see what he has to say about it. If you want to reduce the toxicity of IV cocaine, don't IV it. It's an unsafe ROA for an unsafe drug.

 

[sekio]

In some jurisdictions you can't even do that - it's technically against the law to operate a lemonade stand with no documentation or safety oversight in many places nowadays. Stupid, right? Another "all American" pastime that's been legislated into the gutter of No Fun.

I guess it teaches kids how the corporate world treats small business owners though. Get the kids aspiring to be wage-slave cubicle farmers from a young age instead of becoming anything meaningful.


Also, on the topic of lipid rescue, it seems to me that it introduces more risks than it solves. Plus one vote for "not a good plan".