Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011 Jun;7(2):151-3.
doi: 10.1007/s13181-010-0133-3.

Cardiotoxic overdose treated with intravenous fat emulsion and high-dose insulin in the setting of hypertrophic cardiomyopathy

Samuel J Stellpflug  1 , Sandy J Fritzlar, Jon B Cole, Kristin M Engebretsen, Joel S Holger
Affiliations
Case Reports

Cardiotoxic overdose treated with intravenous fat emulsion and high-dose insulin in the setting of hypertrophic cardiomyopathy

Samuel J Stellpflug et al. J Med Toxicol. 2011 Jun.

Abstract

High-dose insulin (HDI) and intravenous fat emulsion (IFE) are used in overdoses, although rarely combined. To our knowledge, IFE therapy has not been reported in overdoses of diltiazem, metoprolol and amiodarone. We report a severe overdose of these drugs treated with HDI and IFE in a patient with hypertrophic cardiomyopathy (HCM). We also discuss the potential clinical implications of the inotropic effects of HDI in the setting of HCM and the use and efficacy of IFE in this overdose.

PubMed Disclaimer

Comment in

References

    1. Cave G, Harvey M. Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review. Acad Emerg Med. 2009;16:815–824. doi: 10.1111/j.1553-2712.2009.00499.x. - DOI - PubMed
    1. Jamaty C, Bailey B, Larocque A, Notebaert E, Sanogo K, Chauny J. Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol. 2010;48:1–27. doi: 10.3109/15563650903544124. - DOI - PubMed
    1. Shepherd G. Treatment of poisoning caused by beta-adrenergic and calcium-channel blockers. Am J Health Syst Pharm. 2006;63:1828–1835. doi: 10.2146/ajhp060041. - DOI - PubMed
    1. Stellpflug S, Harris C, Engebretsen K, Cole J, Holger J. Intentional overdose with cardiac arrest treated with intravenous fat emulsion. Clin Toxicol. 2010;48(3):227–229. doi: 10.3109/15563650903555294. - DOI - PubMed
    1. Rohrig T, Rundle D, Leifer W. Fatality resulting from metoprolol overdose. J Anal Toxicol. 1987;11:231–232. - PubMed

Publication types