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. 2021 Dec 27;13(12):e20744. doi: 10.7759/cureus.20744

Table 3. Therapies used in literature.

ILE: intravascular lipid emulsion

Treatment Mechanism of action Dose Advantages Disadvantages Successes Failures
Anti-arrhythmic drugs Pharmacological attenuation of arrhythmia Depends on agent Well studied with known effects Drug-induced arrhythmia None Marraffa et al. [15], Enakpene et al. [2]
Sodium bicarbonate Reversal of Na­+ blockade 1 mg/kg loading followed by 0.5 mg/kg every 10 minutes as needed Increased survival in arrhythmia Aggressive treatment can cause metabolic alkalosis and hypokalemia   Enakpene et al. [2], Marraffa et. al. [15]
Isoproterenol Sympathomimetic action 1.25 mL/minute followed by 2–20 mL/minute as needed Rapid onset of action Can cause drug-induced arrhythmia and cardiovascular collapse Vaughn et al. [18], Marraffa et al. [15], Enakpene et al. [2], Spinner et al. [20], Eggleston et al. [19]  
Transvenous pacing Overdrive pacing   Safe and low-risk procedure Requires skill and equipment for placement Vaughn et al. [18], Marraffa et al. [15], Spinner et al. [20], Eggleston et al. [19]  
Lipid emulsion therapy Hydrophobic lipid “sink” for toxin 1.5 mL/kg of 20% ILE followed by 0.25 mg/kg/minute Promising results in general drug toxicity management Protocols are not standardized   Enakpene et al. [2], Marraffa et al. [15]