Post Your Cases > Intralipid administration in nortriptyline auto-intoxication
A patient (woman, 51 years) came in with a nortiptilyne auto-intoxication. Within 10 minutes she passed out. Her partner told the Physician that his wife took 53 tablets of 50mg and 43 tablets of 25mg. The patient developed severe cardiotoxicity (prolonged QT and ventricular tachycardia) and reanimation was started. The patient didn’t response to the regular treatment. A bolus of 105ml Intralipid 20% was administered to the patient, 2 times. The patient stabilized and within a day she was transferred from the ICU to the psychiatric department. Different plasma concentrations were measured: Day 1: Nortrip: 2220ug/L, Nortrip E: 185ug/L, Nortrip Z: 110ug/L Day 2: Lipemic sample: Nortrip:1700ug/L, E: 350ug/L, Z: 200ug/L After ultra-centrifugation: Nortrip 950ug/L, E: 290ug/L, Z:150ug/L Day 3: Nortrip: 660ug/L, E: 154ug/L, Z: 95ug/L
Within 10 minutes she passed out.
Her partner told the Physician that his wife took 53 tablets of 50mg and 43 tablets of 25mg.
The patient developed severe cardiotoxicity (prolonged QT and ventricular tachycardia) and reanimation was started. The patient didn’t response to the regular treatment. A bolus of 105ml Intralipid 20% was administered to the patient, 2 times. The patient stabilized and within a day she was transferred from the ICU to the psychiatric department. Different plasma concentrations were measured:
Day 1: Nortrip: 2220ug/L, Nortrip E: 185ug/L, Nortrip Z: 110ug/L
Day 2: Lipemic sample: Nortrip:1700ug/L, E: 350ug/L, Z: 200ug/L
After ultra-centrifugation: Nortrip 950ug/L, E: 290ug/L, Z:150ug/L
Day 3: Nortrip: 660ug/L, E: 154ug/L, Z: 95ug/L