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Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi

Yıl 2019, Cilt: 12 Sayı: 1, 70 - 77, 30.06.2019

Öz

İntravenöz lipit emülsiyon (ILE) tedavisi,
dolaşımdaki zehirli maddelerin biyoyararlanım ve toksisitesini azaltmak için
lipit emülsiyonlarının intravenöz infüzyon yoluyla kullanılmasını tanımlar.
Lipit emülsiyonu yağ, emülsifier, tonisite değiştirici madde ve sudan oluşurken
ve bileşiminde yaklaşık %80 su, %20 soya fasulyesi yağı, %2 gliserin ve %1
yumurta sarısı fosfolipidi bulunmaktadır. ILE’nin üretilme amacı öncelikli
olarak yetişkinler, çocuklar ve yeni doğanlar için parenteral beslemedir. Bunun
dışında ILE propofol ve amfoterisin B’de olduğu gibi ilaç taşıyıcısı olarak da
kullanılmaktadır. ILE, lipofilik toksinleri absorbe etme yeteneklerine bağlı
olarak veteriner hekimlikte ve insan hekimliğinde lokal anesteziklerin sistemik
toksisitesinin tedavisinde de antidot olarak kullanılabilmektedir. Lipofilik
ilaçlarla zehirlenmelerin tedavisinde belirgin klinik düzelme, uygulamasının
nispeten kolay olması, düşük maliyet, söz konusu lipit emülsiyonlarının etiket
dışı kullanımının artmasına neden olmuş ve zehirlenmelerin tedavisinde
kullanılabilmesinin yolunu açmıştır. Bu makalede ILE’nin etki mekanizmaları,
endikasyonları, mevcut ticari formülasyonları, dozaj rejimi önerisi ile yan
etkileri hakkında bilgi verilmesi amaçlanmaktadır.

Kaynakça

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  • 20. Sirianni AJ, Osterhoudt KC, Calello DP, et al. (2008). Use of Lipid Emulsion in the Resuscitation of a Patient with Prolonged Cardiovascular Collapse After Overdose of Bupropion and Lamotrigine. Ann Emerg Med. 51(4):412-415.
  • 21. Harvey M, Cave G. (2007). Intralipid Outperforms Sodium Bicarbonate in a Rabbit Model of Clomipramine Toxicity. Ann Emerg Med. 49(2):178-185.
  • 22. Khorzad R, Lee JA, Whelan M, et al. (2012). Baclofen Toxicosis in Dogs and Cats: 145 Cases (2004–2010). J Am Vet Med Assoc. 241(8):1059-1064.
  • 23. Dean P, Ruddy J, Marshall S. (2010). Intravenous Lipid Emulsion in Propanolol Overdose. Anaesthesia. 65(11):1148-50.
  • 24. Stellpflug SJ, Harris CR, Engebretsen KM, Cole JB, Holger JS. (2010). Intentional Overdose with Cardiac Arrest Treated with Intravenous Fat Emulsion and High-Dose Insulin. Clin Toxicol. 48(3):227-9.
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  • 31. Bucklin MH, Gorodetsky RM, Wiegand TJ. (2013). Prolonged Lipemia and Pancreatitis Due to Extended Infusion of Lipid Emulsion in Bupropion Overdose. Clin Toxicol. 51(9):896-898.
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  • 35. Perichon D, Turfus S, Gerostamoulos D, Graudins A. (2013). An Assessment of the In Vivo Effects of Intravenous Lipid Emulsion on Blood Drug Concentration and Haemodynamics Following Oro-gastric Amitriptyline Overdose. Clin Toxicol. 51(4):208-215.
  • 36. Fettiplace MR, Akpa BS, Ripper R, et al. (2014). Resuscitation with Lipid Emulsion Dose - Dependent Recovery from Cardiac Pharmacotoxicity Requires a Cardiotonic Effect. Anesthesiology. 120(4):915-25.
  • 37. Fettiplace MR, Akpa BS, Rubinstein I, Weinberg G. (2015). Confusion About Infusion: Rational Volume Limits for Intravenous Lipid Emulsion During Treatment of Oral Overdoses. Ann Emerg Med. 66(2):185.
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  • 46. MacLaren R, Wachsman BA, Swift DK, Kuhl DA. (1997). Warfarin Resistance Associated with İntravenous Lipid Administration: Discussion of Propofol and Review of the Literature. Pharmacotherapy. 17(6):1331-1337.
  • 47. Heijboer AC, Bouman AA, Blankenstein MA, Roelandse-Koop EA. (2010). Intralipid Causes Falsely İncreased Glucose Concentrations with the Hemocue Glucose Analyzer. Clin Chem Lab Med. 48(5):737-738.
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Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Emre Bahçivan Bu kişi benim

Halis Oğuz

Yayımlanma Tarihi 30 Haziran 2019
Kabul Tarihi 24 Ocak 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 12 Sayı: 1

Kaynak Göster

APA Bahçivan, E., & Oğuz, H. (2019). Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi. Dicle Üniversitesi Veteriner Fakültesi Dergisi, 12(1), 70-77.
AMA Bahçivan E, Oğuz H. Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi. Dicle Üniv Vet Fak Derg. Haziran 2019;12(1):70-77.
Chicago Bahçivan, Emre, ve Halis Oğuz. “Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi”. Dicle Üniversitesi Veteriner Fakültesi Dergisi 12, sy. 1 (Haziran 2019): 70-77.
EndNote Bahçivan E, Oğuz H (01 Haziran 2019) Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi. Dicle Üniversitesi Veteriner Fakültesi Dergisi 12 1 70–77.
IEEE E. Bahçivan ve H. Oğuz, “Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi”, Dicle Üniv Vet Fak Derg, c. 12, sy. 1, ss. 70–77, 2019.
ISNAD Bahçivan, Emre - Oğuz, Halis. “Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi”. Dicle Üniversitesi Veteriner Fakültesi Dergisi 12/1 (Haziran 2019), 70-77.
JAMA Bahçivan E, Oğuz H. Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi. Dicle Üniv Vet Fak Derg. 2019;12:70–77.
MLA Bahçivan, Emre ve Halis Oğuz. “Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi”. Dicle Üniversitesi Veteriner Fakültesi Dergisi, c. 12, sy. 1, 2019, ss. 70-77.
Vancouver Bahçivan E, Oğuz H. Zehirlenmelerde İntravenöz Lipit Emülsiyonu Tedavisi. Dicle Üniv Vet Fak Derg. 2019;12(1):70-7.