Enflurane

Enflurane is inhalation anesthetic. Inhaled gases are the mainstay of anesthesia and are primarily used for the maintenance of anesthesia after administration of an intravenous agent. The depth of anesthesia can be rapidly altered by changing the concentration of inhaled anesthetic. Most of the agents are rapidly eliminated from the body and donot cause post-operative respirtory depression.

Brands
ETHRANE
Adult Dose
Dose: 0.5 to 3 %
Single Dose: 1.8 (1.75)
Frequency: As recommended.
Route: Inhalation
Instructions: Maintenance, As Required
Neonatal
Paedriatic
Characteristics
It belongs to General Anesthetics-Volatile pharmacological group on the basis of mechanism of action. The Molecular Weight of Enflurane is 184.50.
Contraindications
Enflurane is contraindicated in conditions like Epilepsy,Renal diseases.
Effects
The severe or irreversible adverse effects of Enflurane, which give rise to further complications include Bronchospasm, Bronchospasm, Asthmatic attack.Enflurane produces potentially life-threatening effects which include Malignant hyperpyrexia. which are responsible for the discontinuation of Enflurane therapy.The signs and symptoms that are produced after the acute overdosage of Enflurane include Depression of vital functions.The symptomatic adverse reactions produced by Enflurane are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Hypotension, Respiratory depression, Shivering, Hiccough, Arrhythmia.
Indications
Enflurane is primarily indicated in conditions like Induction and maintenance of anaesthesia, Reactive airways disease, and can also be given in adjunctive therapy as an alternative drug of choice in Obstetric anaesthesia, Obstetric pain.
Interactions
Enflurane is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcoholAlcuronium (Cl)Amitriptyline (HCl)Amitriptyline (HCl)Atracurium (Besylate)Enflurane may increases the effect of atracurium.ModerateAtracurium dosage must be reduced.DiazepamDiazoxideEnhanced hypotensive effect when Diazoxide given with Enflurane.Diltiazem (HCl)Additive pharmacological actions are reported when enflurane giving with diltiazem.Effects include risk of cardiac depression,hypotension,cardiovascular collapse and ventricular impairment.ModerateHemodynamic and electrocardiographic monitoring are required during operation and discontinuation of diltiazem prior to surgery is not advised in coronary heart disease patient due to rebound effect. DoxacuriumEnflurane may initiate non depolarizing muscle relaxant effect.ModerateEnflurane dosage must be adjusted and administered by specially trained anesthologist.DoxapramEtomidateIsoniazidMetabolite of isoniazid, hydrazine, facilitates the defluorination of enflurane results in increased level of inorganic fluoride in plasma leads to nephrotoxicity.ModerateClosely monitor the renal function prior to surgery.IsoproterenolKetamine (HCl)LignocaineMethotrexateMivacurium (Cl)MorphineNaloxone (HCl)Nitrous OxideNitrous OxidePancuronium (Br)Enflurane potentiate the effects of pancuronium.ModerateDose of pancuronium should be reduce if necessary.PropofolEnflurane can be expected to increase the anesthetic or sedative and cardiorespiratory effects of Propofol Injectable Emulsion.Sotalol (HCl)Vecuronium (Br)Enflurane potentiates the effect of vecuronium.ModerateDose of vecuronium should be reduced. Only specially trained health care providers should administer enflurane. These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Measurement of the Nitrogen and Ox partial pressure by Polarographic & Mass Spectrometric Methods
Risks
Drug should not be given to Pregnant Mothers.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Store . Protect from Sunlight. Inhalation Liq Store in a well closed container. Protect from Heat. Inj Store Below 40°C. Do not Freeze. Protect from Sunlight and Heat.
Warnings
Enflurane should be used with caution in patients with convulsive disorder. Avoid use in patients having susceptibility to malignant hyperthermia. Patients should observed caution while driving or performing other tasks requiring alertness, because may cause drowsiness. Patients with chronic disease such as diabetes or hypertension may require adjustment to their therapy before anesthesia. Anesthetics should be given with caution in patients with cardiac, respiratory, renal or hepatic impairment. It should be used with caution in elderly patients because they often have significantly decreased MACs and are more susceptible to anesthetic-induced hypotension and circulatory depression. It is classified as category B drug, it should be used with caution during pregnancy.
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