# Indications Toxin:: [[Local anaesthetic systemic toxicity]] can be *CONSIDERED* for life-threatening cardiotoxicity caused by lipophilic cardio toxins resistant to other treatments (eg beta blocker overdose or calcium channel blocker overdose or TCA overdose) # Dose - bolus 1.5mL/kg IV of 20% emulsion over 1 min - repeat bolus dose Q5 min if no response, to max dose of 8 doses - Infusion 0.25 mL/kg/min for 30-60 min # pharm MOA - creates an expanded intravenous lipid phase that establishes an equilibria that drives offending drug from target tissues into this newly-formed *lipid sink*. - May also increase intracellular fatty acid content → overcome reduced ATP May change effectiveness of adrenaline during cardiac arrest