Drug Guide

Generic Name

Soybean Oil

Brand Names Intralipid 10%, Intralipid 20%, Soyacal 10%, Travamulsion 10%, Travamulsion 20%, Soyacal 20%, Liposyn III 10%, Liposyn III 20%, Nutrilipid 10%, Nutrilipid 20%, Intralipid 30%, Liposyn III 30%

Classification

Therapeutic: Nutritional Supplement, Parenteral Nutrition

Pharmacological: Lipid Emulsion

FDA Approved Indications

Provision of essential fatty acids and calories in parenteral nutrition for patients unable to obtain adequate nutrition orally or enterally.

Mechanism of Action

Provides a source of calories and essential fatty acids, supporting cellular function and growth by supplying triglycerides that are metabolized to produce energy.

Dosage and Administration

Adult: Typically 10-30% lipid emulsions administered via IV in doses determined by patient needs, usually 1-2 g/kg/day of lipids.

Pediatric: Dosing varies; typically 0.5-3 g/kg/day depending on age and nutritional requirements.

Geriatric: Adjust doses based on nutritional status and weight; monitor for lipid tolerance.

Renal Impairment: Use with caution; monitor triglycerides and nutritional status.

Hepatic Impairment: Use cautiously; hepatic dysfunction may affect lipid metabolism.

Pharmacokinetics

Absorption: Administered intravenously, bypassing absorption processes.

Distribution: Distributed throughout body tissues, incorporated into cell membranes.

Metabolism: Metabolized primarily in the liver.

Excretion: Excreted mainly via metabolic pathways; triglycerides are broken down and fatty acids utilized or stored.

Half Life: Approximately 2-3 days, varies with metabolic rate and lipid clearance.

Contraindications

Hypersensitivity to soybean oil or other components of the emulsion.
Acute liver disease.
Severe hyperlipidemia.

Precautions

Monitor triglyceride levels, especially in patients with impaired lipid metabolism.
Use cautiously in patients with allergy to soy or eggs.

Adverse Reactions - Common

Elevated triglycerides (Common)
Fever, chills during infusion (Common)

Adverse Reactions - Serious

Allergic reactions including anaphylaxis (Uncommon)
Fat overload syndrome (hyperlipidemia, hepatomegaly, fever, ARDS) (Rare)

Drug-Drug Interactions

May interact with medications affecting lipid metabolism (e.g., orlistat).

Drug-Food Interactions

Limited interaction data.

Drug-Herb Interactions

Limited data.

Nursing Implications

Assessment: Monitor triglyceride levels, liver function tests, and for allergic reactions.

Diagnoses:

Imbalanced nutrition: less than body requirements.
Risk for fat overload syndrome.

Implementation: Administer via infusion pump, monitor for adverse reactions, check lipid levels regularly, and ensure proper infusion techniques.

Evaluation: Maintain appropriate nutritional status, absence of adverse reactions, and normal lipid levels.

Patient/Family Teaching

Report any allergic reactions or unusual symptoms.
Explain that it's administered intravenously in a healthcare setting.
Emphasize importance of monitoring during therapy.

Special Considerations

Black Box Warnings:

None explicitly for soybean oil emulsions, but caution in hypersensitive individuals.

Genetic Factors: Possible allergy in individuals with soy or egg allergy.

Lab Test Interference: May affect lipid panels; consider timing of blood tests.

Overdose Management

Signs/Symptoms: Lipid overload, hypertriglyceridemia, shortness of breath, fever, hepatomegaly.

Treatment: Discontinue infusion, monitor triglycerides, supportive care as needed.

Storage and Handling

Storage: Store at room temperature, protected from light.

Stability: Stable until expiration date when stored properly.