lipid emulsion (plant oil-based)

Action and Spectrum

Actions and Spectrum:  

Action:
Anti-Inflammatory Effects: Lipid emulsions like the plant oil-based omega-3 fatty acids have been found to possess anti-inflammatory properties. These may act to diminish inflammation in many pathological conditions, and they may be beneficial in treating patients with inflammatory disease.
Antioxidant Effects: There are plant oil-based lipid emulsions that incorporate natural antioxidants like vitamins E which will be useful in neutralization of free radicals and shielding of cells from oxidation.
Spectrum:
Parenteral Nutrition: Lipid emulsions are an essential part of IV nutrition in patients who cannot take foods orally or even have enteral feeds. They are used for enteral feeding, that is to make up for nutritional needs that cannot be obtained from usual digestion processes, particularly in cases of serious sickness or lack of nutrition.
Hypertriglyceridemia: When triglyceride levels are severely high, known as hypertriglyceridemia, lipid emulsions can be effective and helpful in decreasing circulating triglycerides thus counteracting the effects and risks such as acute pancreatitis that come with it.  

Drug Interaction

Adverse Reaction

Frequency defined  

1% to 10%

Hepatic: Abnormal hepatic function tests (2% to 10%)

Hematologic & oncologic: Hypoproteinemia (2% to 10%)

Gastrointestinal: vomiting (≤10%), Nausea (≤10%)

Endocrine and metabolic: hyperglycemia (2% to 10%) Hyperlipidemia (≤10%)

Frequency not defined 

Infection: Septicemia

Hepatic: hepatomegaly, Fat overload syndrome, increased liver enzymes

Genitourinary: Urinary tract infection

Hematologic & oncologic: Leukopenia, thrombocytopenia, splenomegaly

Gastrointestinal: Cholestasis (central lobular), melanosis (brown fat pigmentation in the reticuloendothelial system)

Cardiovascular: Thrombophlebitis

Black Box Warning

Black Box Warning:   

None   

Contraindication / Caution

Contraindication/Caution:  

Allergy or hypersensitivity

Severe hyperlipidemia

Acute pancreatitis

Severe liver dysfunction

Hypercoagulable states

Sepsis or severe infection

Pregnancy / Lactation

Pregnancy warnings:  

Pregnancy category: N/A

Lactation: Excreted into human milk is unknown

Pregnancy Categories:  

• Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.
• Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
• Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

The lipid emulsions used in primarily plant oil based and the emulsions offer essential fatty acids and calories to the patients in the condition that they are unable to meet their nutritional requirements orally.

Pharmacodynamics:

Lipid emulsions are a concentrated source of calories, containing the essential fatty acids and energy to meet over metabolism requirement. These are often given to patients who are unable to take food orally, those who have poor gut function or anyone who needs supplementary feeding.
The plant oil-based lipid emulsions contain significant fatty acids such as linoleic acid and alpha-linolenic acid which plays multiple roles in the human body’s functions, including cell membrane status, hormone biosynthesis, and immune system activity.

Pharmacokinetics: 

Absorption

A plant oil-based lipid emulsion is administered intravenously, entering the bloodstream directly without oral absorption.

Distribution

Lipids from the emulsion spread throughout the body, supplying energy, forming membranes, and supporting biological functions in cells, tissues, and organs.

Metabolism

Enzymes like lipases break down lipids into fatty acids and glycerol for energy or metabolic processes, primarily in the liver.

Excretion and Elimination

The liver and kidneys primarily excrete breakdown products like fatty acids and glycerol via urine or bile, with minor elimination in feces.

Adminstartion

Administration:  

Intravenous Access: lipid emulsion is given through injection that is administered intravenously. A healthcare professional will facilitate the process in healthcare settings.

Patient Information Leaflet

Patient information leaflet 

Generic Name: lipid emulsion (plant oil-based)

Why do we use lipid emulsion (plant oil-based)?  

Lipid emulsions are frequently incorporated in parenteral nutrition and more frequently in patients requiring adequate nutrition which cannot be achieved through oral intake.

For patients with a damaged digestive system, or for severe cases of critically ill patients, post-operational patients, or patients complaining of a serious case of malabsorption, lipid emulsions can be administered intravenously to supply the body its essential fats, calorie requirements, and fat-soluble vitamins.
Some patients fail to metabolize and absorb dietary fats in the normal required capacity hence essential fatty acid deficiency occurs. Because fatty acids are a component of lipid emulsions, this will effectively replenish fats in the body that are required for various physiological functions.