脂肪乳剤（静注用）
Intravenous Fat Emulsion
Intravenous Lipid Emulsion
別名: Intralipid · Liposyn III · IFE · ILE · Intravenous Lipid Emulsion · Lipid Rescue
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Parenteral Nutrition (PN) | 25-60% of calories administered. Traditionally not recommended at > 2 g/kg/day for TPN therapy. | IV | CRI | As needed | 🌎 NA |
| Rescue agent for fat-soluble drug/toxin intoxication | IFE 20% via a sterile, peripheral IV catheter as a 1.5 mL/kg bolus over 1-3 minutes, then 0.25-0.5 mL/kg/min for 30-60 min. The bolus could be repeated in case of cardiac arrest. If symptomatic after traditional dosing, consider additional doses of 1.5 mL/kg IV over 30 min q4-6h for 24-36 hours until clinical signs resolve, or maintaining a CRI of 0.5 mL/kg/hour until clinical signs resolve. | IV | Bolus followed by CRI | Until clinical signs resolve | 🌎 NA |
- Parenteral Nutrition (PN): Consult a veterinary nutritionist. Keep PPN solutions below 600 mOsm/L.
- Rescue agent for fat-soluble drug/toxin intoxication: Do not exceed 8 mL/kg/day generally, though this has been exceeded in acute toxicosis without ill effect.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Parenteral Nutrition (PN) | 25-60% of calories administered. Traditionally not recommended at > 2 g/kg/day for TPN therapy. | IV | CRI | As needed | 🌎 NA |
| Rescue agent for fat-soluble drug/toxin intoxication | IFE 20% via a sterile, peripheral IV catheter as a 1.5 mL/kg bolus over 1-3 minutes, then 0.25-0.5 mL/kg/min for 30-60 min. The bolus could be repeated in case of cardiac arrest. If symptomatic after traditional dosing, consider additional doses of 1.5 mL/kg IV over 30 min q4-6h for 24-36 hours until clinical signs resolve, or maintaining a CRI of 0.5 mL/kg/hour until clinical signs resolve. | IV | Bolus followed by CRI | Until clinical signs resolve | 🌎 NA |
- Parenteral Nutrition (PN): Consult a veterinary nutritionist.
- Rescue agent for fat-soluble drug/toxin intoxication: Extrapolated from general veterinary/human guidelines.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
静注用脂肪乳剤 (IFE/ILE) は、静脈内投与用に調製された無菌で発熱性物質を含まない脂肪乳剤です。
歴史的には主に経静脈的なカロリーおよび必須脂肪酸の供給源として利用されてきましたが、現在では獣医毒性学における重要な救命解毒剤として注目されています。従来の治療法が効かない場合、脂溶性の高い薬物による生命を脅かす中毒の治療に極めて有効です。
主な臨床応用:
- 中毒の救命治療: 局所麻酔薬（ブピバカイン、リドカイン）、大環状ラクトン類（イベルメクチン、モキシデクチン）、カルシウム拮抗薬（アムロジピン）、β遮断薬、および一部の抗うつ薬/抗精神病薬。
- 経静脈栄養 (PN): 高密度のカロリーを提供します（20%溶液で約2 kCal/mL）。注意: 免疫抑制や感染リスクの可能性があるため、重症患者の栄養管理への使用には議論があります。
作用機序
Toxicologic Mechanism (Antidote):
- "Lipid Sink" Theory: IFE creates an expanded intravascular lipid phase. Highly lipophilic toxins partition out of target tissues (e.g., myocardium, CNS) and into this "lipid sink" within the plasma, reducing the free (active) drug concentration at receptor sites.
- Metabolic/Cardiac Enhancement: Provides a direct energy substrate (free fatty acids) to the myocardium, overcoming mitochondrial lipid metabolism blockade (e.g., by bupivacaine) and increasing intracellular calcium to improve cardiac contractility.
Nutritional Mechanism:
- Provides a dense source of calories and essential fatty acids (linoleic, linolenic acids) necessary for cellular integrity and metabolism.
安全性・警告
禁忌
- Severe egg yolk allergies
- Abnormal fat metabolism
- Premature and low-birth weight infants (human black box warning)
- Blood coagulation disorders
- Pulmonary disease
- Renal impairment
- Severe liver damage
- Patients at high risk for fat emboli
有害事象
- Sepsis or thrombophlebitis (secondary to IV catheterization)
- Fat overload syndrome (hyperlipidemia, hepatomegaly, icterus, splenomegaly, fat embolism, thrombocytopenia, hemolysis, prolonged clotting times)
- Pulmonary toxicity (temporary)
- GI effects
- Somnolence
- Headache
- Flushing
- Pancreatitis
- Hypercoagulability
- Hypersensitivity
注意事項
Strict aseptic technique and excellent IV catheter care are imperative to prevent sepsis. When used alone, IFE may be given via a peripheral line; when combined with amino acids/dextrose as Total Parenteral Nutrition (TPN), a dedicated central line is required due to hypertonicity. Use with caution in critically ill animals due to potential immunosuppression, exacerbation of pulmonary pathology, and increased infection rates. Blood samples for diagnostics should be drawn prior to administration to avoid severe lipemia artifacts (falsely high hemoglobin, MCH, MCHC, and altered bilirubin).
医薬品相互作用
IFE may act as a 'lipid sink', reducing the free circulating levels and clinical efficacy of concurrently administered lipophilic medications.
監視
- Serum/plasma drug levels (for toxicology tracking)
- Blood glucose
- Serum triglycerides and gross lipemia
- PCV and Total Protein
- IV catheter site status (phlebitis/sepsis)
- Hydration status and vital signs (temp, HR, RR)
- Serum electrolytes (including phosphorus)
- Renal and liver function tests
- CBC
- Coagulation times (if using heparin)
薬物動態
吸収
Administered intravenously; 100% bioavailable.
分布
Removed from the blood stream about as rapidly as chylomicrons.
代謝
Requires prior lipolysis of IFE into free fatty acids. Clearance seems to be increased with heparin-activated lipoprotein lipase.
消失
Elimination half-life in humans is about 30 minutes.
過剰投与
In the event of inadvertent overdose or severe fat overload, stop the infusion until the lipid has cleared from the plasma. Clearance can be evaluated visually (inspecting hematocrit tubes for lipemia) or via laboratory methods (triglyceride concentrations, nephelometry).
If severe hyperlipidemia occurs during toxicity treatment, heparin therapy (75-250 Units/kg SQ q6h) may be considered to increase lipid clearance via lipoprotein lipase activation. However, weigh risks carefully, as heparin may alter the antidote mechanism. Monitor PTT; if PTT exceeds 2-2.5X normal, lower heparin dose (75 Units/kg SQ q6-8h) or discontinue.
製品
製剤
- Intravenous injection (10%, 20%, 30% emulsions)
ヒト用医薬品
- Fat Emulsion, Intravenous 10%, 20%, 30% in 50 mL, 100 mL, 200 mL, 250 mL, & 500 mL bottles or bags (Intralipid, Liposyn II, Liposyn III)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store unopened products at room temperature (not above 25°C / 77°F). Do not freeze; discard if accidentally frozen. Once opened, store the remaining product in the refrigerator (2-8°C) and discard after 24 hours. A new bag/vial must be used every 24 hours. Admixtures must be used promptly or stored under refrigeration for 24 hours or less.
飼主向け情報
静注用脂肪乳剤 (IFE) は、病院内でのみ使用される専門的な治療法です。
- 中毒の場合: 血液中で「スポンジ」のように働き、特定の重篤で生命を脅かす毒素（心臓薬、局所麻酔薬、特定の駆虫薬など）を吸収します。標準的な治療が効かない場合の救命治療となります。
- 栄養補給の場合: 食事がとれず、点滴による栄養補給が必要なペットに必須のカロリーと脂肪を提供します。
- 静脈に直接投与されるため、ペットは入院し、静脈カテーテルを留置した上で、感染や血液中の脂肪過多の兆候がないか獣医療チームによる厳密な監視が必要となります。
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