Intravenous Lipid Emulsion Treatment for Propranolol in the Management of Multiple Drug Intoxication


KARABIYIK L. , Kalin B. S. , AKMAN AYDIN E., Nadastepe O.

TURKISH JOURNAL OF INTENSIVE CARE-TURK YOGUN BAKIM DERGISI, cilt.17, sa.4, ss.221-225, 2019 (ESCI İndekslerine Giren Dergi) identifier

  • Cilt numarası: 17 Konu: 4
  • Basım Tarihi: 2019
  • Doi Numarası: 10.4274/tybd.galenos.2019.32932
  • Dergi Adı: TURKISH JOURNAL OF INTENSIVE CARE-TURK YOGUN BAKIM DERGISI
  • Sayfa Sayıları: ss.221-225

Özet

Diagnosis and treatment management is difficult in cases of intoxication with multiple drugs. A 29-year-old female patient was admitted to the emergency department with multiple doses of propranolol, biperidene, risperidone and valproic acid for suicidal purposes. She had cardiovascular collapse despite fluid therapy and multiple high-dose vasopressor infusions. Intravenous lipid emulsion (ILE) treatment was administered to the patient who had hypotension that was resistant to hyperinsulinemic euglycemia and glucagon therapy. Hemodynamic stability was achieved after three hours. Intoxication with beta-blockers may be life threatening Propranolol is a beta-blocker drug that binds highly to plasma proteins and has high lipophilic properties. The classical therapies recommended for severe beta-blocker intoxications may be insufficient, and successful results can be obtained with ILE application. In this case report, we wanted to emphasize that management of multiple drug intoxication is difficult and ILE treatment may be successful in treatment-resistant beta-blocker intoxications.