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Isoflurane, sold under the brand name Forane among others, is a halogenated ether used as a general anesthetic. It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia, due to airway irritation with isoflurane. Isoflurane is a inhalational anesthetic given via inhalation.
Isoflurane was approved for medical use in the United States in 1979. It is on the World Health Organization's List of Essential Medicines.
Isoflurane is always administered in conjunction with air or pure oxygen. Often, nitrous oxide is also used. Although its physical properties imply that anaesthesia can be induced more rapidly than with halothane, its pungency can irritate the respiratory system, negating any possible advantage conferred by its physical properties. Thus, it is mostly used in general anesthesia as a maintenance agent after induction of general anesthesia with an intravenous agent such as thiopentone or propofol.
General anaesthesia with isoflurane reduces plasma endocannabinoid Anandamide concentrations, and this could be a consequence of stress reduction after Unconsciousness.
Serious side effects can include malignant hyperthermia or hyperkalemia. It should not be used in patients with a history of malignant hyperthermia in either themselves or their family members.
It is unknown if its use during pregnancy is safe for the fetus, but use during a cesarean section appears to be safe.
Animal studies have raised safety concerns of certain general anesthetics, in particular ketamine and isoflurane, in young children. The risk of neurodegeneration was increased in combination of these agents with nitrous oxide and benzodiazepines such as midazolam. Whether these concerns occur in humans is unclear.
It is administered as a racemic mixture of ( R)- and ( S)-optical isomers. It is non-combustible but can give off irritable and Toxicity fumes when exposed to flame.
Elderly
Biophysical studies using NMR spectroscopy has provided molecular details of how inhaled anesthetics interact with three amino acid residues (G29, A30 and I31) of amyloid beta peptide and induce aggregation. This area is important as "some of the commonly used inhaled anesthetics may cause brain damage that accelerates the onset of Alzheimer's disease".
Anesthetic Physical properties
Isoflurane has a Minimum alveolar concentration (MAC) of 1.15 vol %. The blood/gas partition coefficient is 1.4, and the oil/gas partition coefficient is 98. Its vapor pressure at is .
History
Together with enflurane and halothane, Isoflurane began to replace the flammable Diethyl ether used in the pioneer days of surgery; this shift began in the 1940s to the 1950s. Its name comes from being a structural isomer of enflurane, hence they have the same empirical formula.
Environment
The average lifetime of isoflurane in the atmosphere is 3.2 years, its global warming potential is 510 (times greater than carbon dioxide) and yearly emissions as of 2015 were 880 tons.
Veterinary use
Isoflurane is used for the induction and maintenance of general anesthesia in horses and dogs.
External links
Categories: 5-ht3 Receptor Positive Allosteric Modulators, Difluoromethoxy Compounds, Ethers, Fluranes, Gabaa Receptor Positive Allosteric Modulators, General Anesthetics, Glycine Receptor Agonists, Nicotinic Antagonists, Nmda Receptor Antagonists, Organochlorides, Organofluorides, Psychoplastogens, Trifluoroethyl Compounds, World Health Organization Essential Medicines, Wikipedia Medicine Articles Ready To Translate
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