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Jones E, Walton SA, Davis J, Council-Troche M. An in vitro evaluation of intravenous lipid emulsion on three common canine toxicants. Front Vet Sci 2024; 11:1482871. [PMID: 39386250 PMCID: PMC11461450 DOI: 10.3389/fvets.2024.1482871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Accepted: 09/10/2024] [Indexed: 10/12/2024] Open
Abstract
Objective To determine whether intravenous lipid emulsion (ILE) therapy significantly reduces the concentration of baclofen, ibuprofen, and/or bromethalin in canine whole blood over time. Animals Seven 500 mL bags of canine DEA 1.1 negative blood were divided into aliquots of 125 mL and randomly assigned to one of three treatment groups (baclofen, ibuprofen, bromethalin) or four control groups (a positive control for each treatment group and a negative control group). Procedures Injectable ibuprofen (200 mg/kg), baclofen (8 mg/kg), or bromethalin (3 mg/kg) was apportioned into 125 mL aliquots of canine whole blood and incubated for 30 min at 38.5°C. ILE (12.4 mL, Intralipid® ) was added to each sample and the solution vortexed [215 rpm for 15 min at 37°C (98.6°F)]. Samples were obtained at designated time points (0, 15, 30, 60, 180, 360 min), centrifuged, and separated into serum and RBC fractions. Serum samples were ultracentrifuged (22,000 g for 10 min at 37°C) to separate lipid rich and poor fractions. Samples were stored at -80°C prior to analysis. Results A significant decrease in total drug concentration was established for bromethalin and its metabolite desmethylbromethalin compared to positive controls. ILE significantly reduced desmethylbromethalin at the 30-and 360-min time points. The remainder of the desmethylbromethalin time points did not reach significance. Bromethalin concentration was significantly reduced at all time points compared to positive controls. Neither baclofen nor ibuprofen had significant changes in concentration. Conclusion ILE therapy was effective at reducing the total drug concentration of bromethalin and its metabolite desmethylbromethalin supporting the lipid sink theory. As a single compartment in vitro study, this study does not evaluate other proposed mechanisms of action of ILE therapy. ILE therapy may have other means of significantly decreasing lipophilic drug concentration in cases of toxicosis.
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Affiliation(s)
- Emery Jones
- Desert Veterinary Medical Specialist, Phoenix, AZ, United States
| | - Stuart A. Walton
- Department of Small Animal Clinical Science, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Jennifer Davis
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virgina Tech, Blacksburg, VA, United States
| | - McAlister Council-Troche
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virgina Tech, Blacksburg, VA, United States
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Matula E, Mastrocco A, Prittie J, Donovan T. Delayed transforaminal brain herniation in a cat following bromethalin intoxication. J Vet Emerg Crit Care (San Antonio) 2024; 34:502-508. [PMID: 39099308 DOI: 10.1111/vec.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/08/2023] [Accepted: 06/25/2023] [Indexed: 08/06/2024]
Abstract
OBJECTIVE To report a case of delayed death after initial successful treatment of severe bromethalin intoxication in a cat. CASE SUMMARY A 2-year-old neutered male domestic shorthair cat presented as a referral for bromethalin toxicosis and progressive neurological decline. At the time of referral, the cat was nonambulatory tetraparetic with minimal motor function in all 4 limbs and exhibited a dull mentation. Within the first 4 hours of hospitalization, the cat's neurological status continued to rapidly decline, and osmotherapy, corticosteroids, and intralipids were administered. The treatment regimen also included levetiracetam, thiamine, cholestyramine, vitamin E, and gingko biloba. Six days after bromethalin ingestion, the cat displayed marked neurological improvement with near normal mentation and mild tetraparesis and was discharged. The cat continued to do well at home with improving neurological status and function. Nine days after discharge, the cat was presented dead on arrival. Postmortem examination revealed transforaminal brain herniation secondary to spongy degeneration of the white matter and increased intracranial pressure as the cause of death. NEW INFORMATION PROVIDED To the authors' knowledge, this is the first report of a cat that suffered delayed death despite initial neurological improvement after being treated for severe bromethalin toxicosis.
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Affiliation(s)
- Erica Matula
- Department of Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Alicia Mastrocco
- Department of Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Jennifer Prittie
- Department of Emergency and Critical Care, The Animal Medical Center, New York, New York, USA
| | - Taryn Donovan
- Department of Anatomic Pathology, The Animal Medical Center, New York, New York, USA
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3
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Hays H. Emergency Medicine Case Study on Local Anesthetic Systemic Toxicity. Adv Emerg Nurs J 2024; 46:234-240. [PMID: 39094084 DOI: 10.1097/tme.0000000000000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
The purpose of this case study on local anesthetic systemic toxicity (LAST), a potentially life-threatening complication of local anesthetic, is to ensure that emergency nurse practitioners (ENPs) are knowledgeable on this disease process. Local anesthetics are used frequently, often daily, by ENPs, as well as multiple other health care providers for various procedures. They should be knowledgeable of the steps to resuscitate a patient who may have severe LAST. This case study reviews the emergency management of LAST, including pharmacologic treatment, deviations from routine advanced resuscitative guidelines, and disposition of the patient upon successful resuscitation. Additionally, risk assessment and clinical manifestations will be discussed. After reviewing this case study, ENPs should be able to recognize the presentation of LAST and provide emergent management to reduce complications, comorbidities, and death.
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Affiliation(s)
- Haley Hays
- Author Affiliation: Western Division, University of Nebraska Medical Center College of Nursing, Scottsbluff, NE, United States; and Emergency Medicine, Aligned Providers of Wyoming, Kimball, NE, United States
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Barreto Bellusci H, Gervasoni LF, Peixoto IC, De Oliveira LB, de Oliveira Vieira KC, Toledo ACCG, de Oliveira CBS, Mareco EA, Naga RM, Cataneli VP, Nai GA, Winkelströter LK. Local anesthetics as a tool for Staphylococcus spp. control: a systematic review. Braz J Microbiol 2024; 55:1427-1435. [PMID: 38386261 PMCID: PMC11153409 DOI: 10.1007/s42770-024-01285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
The objective of this work was to carry out a systematic review on the effectiveness of local anesthetics as antimicrobial agents against Staphylococcus spp. Searches were performed in the PubMed, Web of science, Scopus, Embase and Lilacs databases. As inclusion criteria, complete original articles, with in vitro experimental tests with the application of selected anesthetics and bacteria of the genus Staphylococcus spp. This review followed the methodological checklist for writing papers reporting systematic reviews by the PRISMA statement. The risk of bias was assessed according to the JBI critical appraisal checklist. Analysis was performed using an anesthetic-moderated simple linear regression model. This systematic review was registered by the Open Science Framework-OSF ( https://doi.org/10.17605/OSF.IO/C5JM7 ). Initially, 1141 articles were found, of which, after careful selection, 52 articles were analyzed. Lidocaine was the most commonly used anesthetic, being evaluated in 35 of the articles. S. aureus ATCC 25923 was the standard microorganism in 17 articles. The impact of the anesthetic concentration in relation to the antimicrobial effect was evaluated and the results showed that there was no statistically significant difference. (F [5, 12] = 0.688 p = 0.642), even when taking into account the moderator effect of anesthetics individually. Therefore, although the antimicrobial effect of local anesthetics was demonstrated in 82.7% of the studies evaluated, great heterogeneity of the results was found, which made it impossible to carry out a meta-analysis and make recommendations based on the evidence.
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Affiliation(s)
- Henrique Barreto Bellusci
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Letícia Franco Gervasoni
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Inaiá Calegari Peixoto
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Lívia Batista De Oliveira
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | | | - Ana Clara Campagnolo Goncalves Toledo
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Crystian Bitencourt Soares de Oliveira
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Edson Assunção Mareco
- Programa de Pós-Graduação Em Meio Ambiente E Desenvolvimento Regional, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Raju Maddela Naga
- Facultad de Ciencias de La Salud, Universidad Técnica de Manabí, Portoviejo, Ecuador
| | - Valeria Pereira Cataneli
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
| | - Gisele Alborgheti Nai
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil
- Programa de Pós-Graduação Em Ciência Animal, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil
| | - Lizziane Kretli Winkelströter
- Mestrado Em Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil.
- Faculdade de Ciências da Saúde, Universidade Do Oeste Paulista/UNOESTE, Rua José Bongiovani, 700, Cidade Universitária, Presidente Prudente, SP, Brasil.
- Programa de Pós-Graduação Em Ciência Animal, Universidade Do Oeste Paulista/UNOESTE, Presidente Prudente, SP, Brasil.
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Sun ZG, Xu SC, Yang Q, Yao Y, Mao QL, He CF, Guan CJ, Du Y, Ma L, Huang XS, Hou XL, Yang HM, Peng X, Jian JJ. Successful Treatment of Severe Case of Lipid Overload Syndrome with Pancreatitis and Pneumonia: A Case Report. Int Med Case Rep J 2024; 17:471-477. [PMID: 38774710 PMCID: PMC11108078 DOI: 10.2147/imcrj.s463244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/12/2024] [Indexed: 05/24/2024] Open
Abstract
Background Fat overload syndrome is a rare and severe adverse reaction triggered by the infusion of a single source of lipid emulsion, resulting in elevated blood triacylglycerol (TG) levels. The majority of literature reports focus on cases of fat overload syndrome in patients with mild symptoms. This case is significant because it demonstrates the diagnostic and therapeutic experience and provide valuable insights for the management for severe fat overload syndrome. Case Presentation We present a case report of a female patient who developed fat overload syndrome following prolonged and excessive infusion of lipid emulsion after colon resection surgery. In the setting of compromised immune function and malnutrition, the patient's pulmonary infection and respiratory distress symptoms have further exacerbated. Hence, in addition to severe pancreatitis, the patient has also contracted severe pneumonia. Upon admission, tracheal intubation, plasma exchange and blood perfusion were performed. Subsequently, comprehensive treatment was provided, including anti-infection, antispasmodic, acid suppression, enzyme inhibition, as well as targeted supportive measures to stabilize electrolytes and nutritional status. After treatment, there was a progressive reduction in blood lipid levels. After assessing the relevant risks, it was deemed necessary to perform an emergency computed tomography (CT)-guided percutaneous drainage tube placement procedure targeting the necrotic area of the pancreas while the patient was still intubated. Finally, the patient was discharged from the hospital. Conclusion The case highlights the association between fat overload syndrome and pancreatitis as well as the use of lipid emulsions and suggests the treatment strategies for severe fat overload syndrome.
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Affiliation(s)
- Zi-Guo Sun
- Department of Intensive Care and Emergency Center, Bazhong Hospital of Integrated Chinese and Western Medicine, Bazhong, Sichuan, 636600, People’s Republic of China
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Shi-Cheng Xu
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Qin Yang
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Yun Yao
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Qi-Long Mao
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Cheng-Feng He
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Chang-Jiang Guan
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Yan Du
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Li Ma
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Xie-Shan Huang
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Xiao-Long Hou
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Hong-Mei Yang
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Xia Peng
- Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan, 636600, People’s Republic of China
| | - Jun-Jie Jian
- Department of Health Management, Bazhong Center for Health Education and Health Management, Bazhong, Sichuan, 636600, People’s Republic of China
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Lundgren S, Dreimanis K, Engdahl K, Windahl U, Tegner C. Alpha-chloralose poisoning in 25 cats: clinical picture and evaluation of treatment with intravenous lipid emulsion. J Feline Med Surg 2024; 26:1098612X241235776. [PMID: 38687210 PMCID: PMC11103310 DOI: 10.1177/1098612x241235776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVES The aims of this study were to describe the clinical picture and progression in cats with alpha-chloralose (AC) intoxication and to determine if treatment with intravenous (IV) lipid emulsion (ILE) influenced either the serum concentration of AC or the clinical signs. METHODS Cats with suspected AC poisoning admitted to a university small animal hospital were included. The cats were randomised into two groups: one receiving 20% ILE at a dose of 300 mg/kg as a 2 min bolus, followed by a 1500 mg/kg continuous rate infusion over 30 mins (IL+ group) and the other receiving IV fluid therapy with Ringer's acetate (IL- group). Serum samples were drawn at 0, 2, 12 and 24 h after admission. Samples were tested for AC with a novel validated, quantitative, ultra-high-performance liquid chromatography-tandem mass spectrometry method. Vital and predefined clinical signs were noted at the times of sampling and patients were scored using a previously described intoxication severity score. Telephone interviews were conducted after discharge to assess outcome. RESULTS A total of 25 cats were enrolled: 13 cats in the IL+ group and 12 in the IL- group. The most common clinical signs at presentation were tremor (n = 22, 88.0%), cranial nerve deficits (n = 20, 80.0%) and bradycardia (n = 19, 76.0%). No significant difference in AC concentration or change in intoxication score over time was found between the IL+ and IL- groups at any time point (P >0.05). All cats recovered within 72 h. CONCLUSIONS AND RELEVANCE ILE did not have any effect on the AC serum concentration or clinical signs in AC-poisoned cats. All cats survived until follow-up. In cats with an acute onset of the described neurological signs, AC intoxication is an important differential diagnosis with an excellent prognosis.
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Affiliation(s)
- Sandra Lundgren
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
- AWAKE Animal Hospital, Stockholm, Sweden
| | - Kristoffer Dreimanis
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Evidensia (Uppsala Veterinary Clinic), Uppsala, Sweden
| | - Karolina Engdahl
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ulrika Windahl
- Swedish National Veterinary Institute (SVA), Uppsala, Sweden
| | - Cecilia Tegner
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Dreese K, Odunayo A, Bucknoff MC. Case report: Treatment of cyclobenzaprine ingestion in two dogs with intravenous intralipid therapy. Front Vet Sci 2024; 11:1354028. [PMID: 38410740 PMCID: PMC10894977 DOI: 10.3389/fvets.2024.1354028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction The objective of this case series is to describe the clinical signs and outcome of cyclobenzaprine ingestion in two dogs treated with intralipid emulsion (ILE) and supportive care. Case or series summary Two dogs presented for evaluation of cyclobenzaprine ingestion. A 4-year-old female spayed Rat Terrier (dog 1) presented within 4 h of ingestion of cyclobenzaprine (between 9.7 and 25.9 mg/kg). The dog experienced abnormal behavior, agitation, tremors, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. The dog was treated with ILE, cyproheptadine, and activated charcoal. All clinical signs resolved after treatment. A 5-month-old female intact mixed-breed dog (dog 2) presented after ingestion of an unknown amount of cyclobenzaprine 2-3 h prior to presentation. The dog experienced dull mentation, tremors, loss of gag reflex, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. Orogastric decontamination was performed via gastric lavage, and activated charcoal was given via orogastric tube, followed by ILE. All clinical signs resolved after therapeutic intervention. Discussion This is the first report documenting clinical signs of cyclobenzaprine toxicity in two dogs followed by successful treatment with gastric emptying, ILE, and supportive care.
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Affiliation(s)
- Kaitlyn Dreese
- College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Adesola Odunayo
- College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Melissa C Bucknoff
- Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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Anya OC, Ajayi ER, Solanke HR, Ohanaka AI, Ubana KD. The Use of Intralipid Infusions in the Prevention of Embryo Implantation Failure. Cureus 2024; 16:e53368. [PMID: 38435143 PMCID: PMC10907924 DOI: 10.7759/cureus.53368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Intralipids have been suggested to suppress uterine natural killer cell activity, which could potentially improve implantation rates in women with recurrent loss. We report a case of a 41-year-old African woman with recurrent pregnancy loss who had elevated uterine killer cell activity and for whom intralipid infusion was used to achieve pregnancy. We recommend routine uterine natural killer cell testing for women with recurrent pregnancy loss and further research on newer intravenous lipid emulsions in fertility medicine.
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Affiliation(s)
- Okorie C Anya
- Reproductive Medicine, Primecare Fertility Clinic, Abuja, NGA
| | - Eniola R Ajayi
- Public Health, Central Michigan University College of Medicine, Michigan, USA
| | - Henry R Solanke
- Food Safety and Quality Assurance, Sensei Ag, Aldergrove, CAN
| | - Adaeze I Ohanaka
- Obstetrics and Gynaecology, South Qunfudah General Hospital, Jizan, SAU
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Noev A, Morozova N, Suvorov N, Vasil’ev Y, Pankratov A, Grin M. Development of a Dosage form for a Photoswitchable Local Anesthetic Ethercaine. Pharmaceuticals (Basel) 2023; 16:1398. [PMID: 37895869 PMCID: PMC10609944 DOI: 10.3390/ph16101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The toxicity of local anesthetics is a serious problem, given their widespread use. One of the main causes of the side effects of local anesthetics is their non-selectivity of action in the body. A possible way to increase the selectivity of the action of drugs is to use the photopharmacology approach. Previously, we described the light-controlled local anesthetic ethercaine, the biological effect of which can be controlled using light, thereby increasing its selectivity of action. An important limitation of ethercaine was its low solubility in water, limiting the potential of this compound. In this work, we developed a dosage form of ethercaine, which allowed us to increase its solubility from 0.6% to 2% or more. The resulting 1% solution of ethercaine hydrochloride in 4% Kolliphor ELP had high biological activity on the surface anesthesia model, while demonstrating low acute toxicity in mice with intravenous administration (4-5 times less than that of lidocaine).
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Affiliation(s)
- Alexey Noev
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (N.S.); (A.P.); (M.G.)
- P. Hertsen Moscow Oncology Research Institute — the Branch of the FSBI “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation, 2nd Botkinsky pr. 3, 125284 Moscow, Russia;
| | - Natalia Morozova
- P. Hertsen Moscow Oncology Research Institute — the Branch of the FSBI “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation, 2nd Botkinsky pr. 3, 125284 Moscow, Russia;
| | - Nikita Suvorov
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (N.S.); (A.P.); (M.G.)
| | - Yuriy Vasil’ev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya St. Bldg. 8/2, 119435 Moscow, Russia;
| | - Andrei Pankratov
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (N.S.); (A.P.); (M.G.)
- P. Hertsen Moscow Oncology Research Institute — the Branch of the FSBI “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation, 2nd Botkinsky pr. 3, 125284 Moscow, Russia;
| | - Mikhail Grin
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (N.S.); (A.P.); (M.G.)
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Ma H, Pan Z, Lai B, Zan C, Liu H. Recent Research Advances in Nano-Based Drug Delivery Systems for Local Anesthetics. Drug Des Devel Ther 2023; 17:2639-2655. [PMID: 37667787 PMCID: PMC10475288 DOI: 10.2147/dddt.s417051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/01/2023] [Indexed: 09/06/2023] Open
Abstract
From a clinical perspective, local anesthetics have rather widespread application in regional blockade for surgery, postoperative analgesia, acute/chronic pain control, and even cancer treatments. However, a number of disadvantages are associated with traditional local anesthetic agents as well as routine drug delivery administration ways, such as neurotoxicity, short half-time, and non-sustained release, thereby limiting their application in clinical practice. Successful characterization of drug delivery systems (DDSs) for individual local anesthetic agents can support to achieve more efficient drug release and prolonged duration of action with reduced systemic toxicity. Different types of DDSs involving various carriers have been examined, including micromaterials, nanomaterials, and cyclodextrin. Among them, nanotechnology-based delivery approaches have significantly developed in the last decade due to the low systemic toxicity and the greater efficacy of non-conventional local anesthetics. Multiple nanosized materials, including polymeric, lipid (solid lipid nanoparticles, nanostructured lipid carriers, and nanoemulsions), metallic, inorganic non-metallic, and hybrid nanoparticles, offer a safe, localized, and long-acting solution for pain management and tumor therapy. This review provides a brief synopsis of different nano-based DDSs for local anesthetics with variable sizes and structural morphology, such as nanocapsules and nanospheres. Recent original research utilizing nanotechnology-based delivery systems is particularly discussed, and the progress and strengths of these DDSs are highlighted. A specific focus of this review is the comparison of various nano-based DDSs for local anesthetics, which can offer additional indications for their further improvement. All in all, nano-based DDSs with unique advantages provide a novel direction for the development of safer and more effective local anesthetic formulations.
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Affiliation(s)
- He Ma
- Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, People’s Republic of China
| | - Zhenxiang Pan
- Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, People’s Republic of China
| | - Bingjie Lai
- Department of Intensive Care Unit, The Second Hospital of Jilin University, Changchun, People’s Republic of China
| | - Chunfang Zan
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, People’s Republic of China
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, People’s Republic of China
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Hegde V, Dalia T, Tayeb T, Vidic A. Reply to the letter to the editor. Eur Heart J Case Rep 2023; 7:ytad241. [PMID: 37252203 PMCID: PMC10212576 DOI: 10.1093/ehjcr/ytad241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Vishwajit Hegde
- Resident, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Tarun Dalia
- Fellow, Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Taher Tayeb
- Fellow, Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrija Vidic
- Assistant Professor, Department of Cardiovascular Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66103, USA
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Pashirova TN, Shaihutdinova ZM, Mironov VF, Masson P. Biomedical Nanosystems for In Vivo Detoxification: From Passive Delivery Systems to Functional Nanodevices and Nanorobots. Acta Naturae 2023; 15:4-12. [PMID: 37153510 PMCID: PMC10154777 DOI: 10.32607/actanaturae.15681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 05/09/2023] Open
Abstract
The problem of low efficiency of nanotherapeutic drugs challenges the creation of new alternative biomedical nanosystems known as robotic nanodevices. In addition to encapsulating properties, nanodevices can perform different biomedical functions, such as precision surgery, in vivo detection and imaging, biosensing, targeted delivery, and, more recently, detoxification of endogenous and xenobiotic compounds. Nanodevices for detoxification are aimed at removing toxic molecules from biological tissues, using a chemical- and/or enzyme-containing nanocarrier for the toxicant to diffuse inside the nanobody. This strategy is opposite to drug delivery systems that focus on encapsulating drugs and releasing them under the influence of external factors. The review describes various kinds of nanodevices intended for detoxification that differ by the type of poisoning treatment they provide, as well as the type of materials and toxicants. The final part of the review is devoted to enzyme nanosystems, an emerging area of research that provides fast and effective neutralization of toxins in vivo.
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Affiliation(s)
- T. N. Pashirova
- Arbuzov Institute of Organic and Physical Chemistry, FRC Kazan Scientific Center of RAS, Kazan, 420088 Russian Federation
| | - Z. M. Shaihutdinova
- Arbuzov Institute of Organic and Physical Chemistry, FRC Kazan Scientific Center of RAS, Kazan, 420088 Russian Federation
- Kazan (Volga Region) Federal University, Kazan, 420008 Russian Federation
| | - V. F. Mironov
- Arbuzov Institute of Organic and Physical Chemistry, FRC Kazan Scientific Center of RAS, Kazan, 420088 Russian Federation
| | - P. Masson
- Kazan (Volga Region) Federal University, Kazan, 420008 Russian Federation
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Myocardial Cell Preservation from Potential Cardiotoxic Drugs: The Role of Nanotechnologies. Pharmaceutics 2022; 15:pharmaceutics15010087. [PMID: 36678717 PMCID: PMC9865222 DOI: 10.3390/pharmaceutics15010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Cardiotoxic therapies, whether chemotherapeutic or antibiotic, represent a burden for patients who may need to interrupt life-saving treatment because of serious complications. Cardiotoxicity is a broad term, spanning from forms of heart failure induction, particularly left ventricular systolic dysfunction, to induction of arrhythmias. Nanotechnologies emerged decades ago. They offer the possibility to modify the profiles of potentially toxic drugs and to abolish off-target side effects thanks to more favorable pharmacokinetics and dynamics. This relatively modern science encompasses nanocarriers (e.g., liposomes, niosomes, and dendrimers) and other delivery systems applicable to real-life clinical settings. We here review selected applications of nanotechnology to the fields of pharmacology and cardio-oncology. Heart tissue-sparing co-administration of nanocarriers bound to chemotherapeutics (such as anthracyclines and platinum agents) are discussed based on recent studies. Nanotechnology applications supporting the administration of potentially cardiotoxic oncological target therapies, antibiotics (especially macrolides and fluoroquinolones), or neuroactive agents are also summarized. The future of nanotechnologies includes studies to improve therapeutic safety and to encompass a broader range of pharmacological agents. The field merits investments and research, as testified by its exponential growth.
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Harris S, McMichael MA, Harmon R, Boothe D. Case Report: Successful Intravenous Lipid Emulsion Therapy for Canine Amphetamine Toxicosis. Front Vet Sci 2022; 9:938021. [PMID: 35903141 PMCID: PMC9315424 DOI: 10.3389/fvets.2022.938021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022] Open
Abstract
A 4-year-old, female-spayed, mixed breed dog, weighing 24.2 kg, was presented for acute ingestion of ~12.3 mg/kg of Adderall XRⓇ, an extended-release amphetamine medication. In dogs, the oral median lethal dose for amphetamines ranges anywhere from 9–11 mg/kg to 20–27 mg/kg. On presentation, the patient was agitated, tachycardic and hypertensive. Initial treatment was instituted with intravenous lipid emulsion (IVLE) therapy, and baseline and post-treatment amphetamine concentrations were quantified in serum and plasma. In both serum and plasma, post-IVLE concentrations of amphetamine were lower 1 h after treatment and IVLE was the only treatment instituted during this time. The dog improved significantly while in hospital and was discharged <24 h after presentation. This is the first known reported use of IVLE for treatment of amphetamine toxicosis with documented decreases in both serum and plasma amphetamine levels shortly after administration of IVLE.
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Affiliation(s)
- Stephanie Harris
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, United States
| | - Maureen A. McMichael
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL, United States
- *Correspondence: Maureen A. McMichael
| | - Roy Harmon
- Department of Anatomy, Physiology and Pharmacology, Auburn University College of Veterinary Medicine, Auburn, AL, United States
| | - Dawn Boothe
- Department of Anatomy, Physiology and Pharmacology, Auburn University College of Veterinary Medicine, Auburn, AL, United States
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15
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Djamgoz MBA. Combinatorial Therapy of Cancer: Possible Advantages of Involving Modulators of Ionic Mechanisms. Cancers (Basel) 2022; 14:2703. [PMID: 35681682 PMCID: PMC9179511 DOI: 10.3390/cancers14112703] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
Cancer is a global health problem that 1 in 2-3 people can expect to experience during their lifetime. Several different modalities exist for cancer management, but all of these suffer from significant shortcomings in both diagnosis and therapy. Apart from developing completely new therapies, a viable way forward is to improve the efficacy of the existing modalities. One way is to combine these with each other or with other complementary approaches. An emerging latter approach is derived from ionic mechanisms, mainly ion channels and exchangers. We evaluate the evidence for this systematically for the main treatment methods: surgery, chemotherapy, radiotherapy and targeted therapies (including monoclonal antibodies, steroid hormones, tyrosine kinase inhibitors and immunotherapy). In surgery, the possible systemic use of local anesthetics to suppress subsequent relapse is still being discussed. For all the other methods, there is significant positive evidence for several cancers and a range of modulators of ionic mechanisms. This applies also to some of the undesirable side effects of the treatments. In chemotherapy, for example, there is evidence for co-treatment with modulators of the potassium channel (Kv11.1), pH regulation (sodium-hydrogen exchanger) and Na+-K+-ATPase (digoxin). Voltage-gated sodium channels, shown previously to promote metastasis, appear to be particularly useful for co-targeting with inhibitors of tyrosine kinases, especially epidermal growth factor. It is concluded that combining current orthodox treatment modalities with modulators of ionic mechanisms can produce beneficial effects including (i) making the treatment more effective, e.g., by lowering doses; (ii) avoiding the onset of resistance to therapy; (iii) reducing undesirable side effects. However, in many cases, prospective clinical trials are needed to put the findings firmly into clinical context.
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Affiliation(s)
- Mustafa B. A. Djamgoz
- Department of Life Sciences, Imperial College London, South Kensington Campus, London SW7 2AZ, UK; ; Tel.: +44-796-181-6959
- Biotechnology Research Centre, Cyprus International University, Haspolat, Mersin 10, Turkey
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