Isoflurane
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| Image:Isoflurane2.png | |
| Image:Isoflurane-3D-vdW.png | |
| Isoflurane
| |
| Systematic (IUPAC) name | |
| 2-chloro-2-(difluoromethoxy)-1,1,1-trifluoro-ethane | |
| Identifiers | |
| CAS number | |
| ATC code | N01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C3H2ClF5O |
| Mol. mass | 184.5 g/mol |
| Pharmacokinetic data | |
| Bioavailability | ? |
| Metabolism | ? |
| Half life | ? |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
? |
| Legal status | |
| Routes | ? |
Isoflurane (2-chloro-2-(difluoromethoxy)-1,1,1-trifluoro-ethane) is a halogenated ether used for inhalational anesthesia. Together with enflurane and halothane, it replaced the flammable ethers used in the pioneer days of surgery. Its use in human medicine is now starting to decline, being replaced with sevoflurane, desflurane and the intravenous anaesthetic propofol. Isoflurane is still frequently used for veterinary anaesthesia.
Isoflurane is always administered in conjunction with air and/or pure oxygen. Often nitrous oxide is also used. Although its physical properties means that anaesthesia can be induced more rapidly than with halothane, its pungency can irritate the respiratory system, negating this theoretical advantage conferred by its physical properties. It is usually used to maintain a state of general anesthesia that has been induced with another drug, such as thiopentone or propofol. It vaporizes readily, but is a liquid at room temperature. It is completely non-flammable.
A major advantage of isoflurane is that the patent covering its use has expired, therefore it is very economical to use.
Physical properties
| Molecular weight | 184.5g/mol | ||
| Boiling point (at 1 atm): | 48.5 °C | ||
| Density (at 25 °C): | 1.496 g/mL | ||
| MAC : | 1.15 vol % | ||
| Vapor pressure: | 238 mmHg | 31.7 kPa | (at 20°C) |
| 295 mmHg | 39.3 kPa | (at 25°C) | |
| 367 mmHg | 48.9 kPa | (at 30°C) | |
| 450 mmHg | 60.0 kPa | (at 35°C) | |
| Water Solubility | Insoluble | ||
| Blood:Gas Partition coefficient: | 1.4 | ||
| Oil:Gas Partition coefficient: | 98 |
Mechanism of action
Isoflurane reduces pain sensitivity (analgesia) and relaxes muscles. The mechanism by which general anesthetics produce the anesthetic state is not clearly understood but likely involves interactions with multiple receptor sites to interfere with synaptic transmission. Isoflurane binds to GABA receptors, glutamate receptors and glycine receptors, and also inhibits conduction in activated potassium channels. Glycine inhibition helps to inhibit motor function, while bonding to glutamate receptors mimics the efects of NDMA. It activates calcium ATPase through an increase in membrane fluidity, and binds to the D subunit of ATP synthase and NADH dehydrogenase. In addition, a number of general anesthetics attenuate gap junction commmunication, which could contribute to anesthetic action.
Possible link to cognitive decline
Isoflurane exposure has been shown to induce cognitive decline in mice.[1] Exposure of cultured human cells to isoflurane has been reported to induce apoptosis and accumulation and aggregation of amyloid beta protein.[2] Further research will be required to establish whether or not clinical exposure to isoflurane leads to dementia (Alzheimer's disease).[3][4]
References
- ↑ S. L. Bianchi, T. Tran, C. Liu, S. Lin, Y. Li, J. M. Keller, R. G. Eckenhoff, M. F. Eckenhoff (2007). "Brain and behavior changes in 12-month-old Tg2576 and nontransgenic mice exposed to anesthetics". Neurobiology of Aging 28 (in press): in press. doi:10.1016/j.neurobiolaging.2007.02.009.
- ↑ Z. Xie, Y. Dong, U. Maeda, R. D. Moir, W. Xia, D. J. Culley, G. Crosby, R. E. Tanzi (2007). "The Inhalation Anesthetic Isoflurane Induces a Vicious Cycle of Apoptosis and Amyloid β-Protein Accumulation". Journal of Neuroscience 27 (6): 1247-1254. doi:10.1523/JNEUROSCI.5320-06.2007.
- ↑ M. C. Lewis, I. Nevoa, M. A. Paniaguaa, A. Ben-Aric, E. Prettoa, S. Eisdorfera, E. Davidsona, I. Matotc, C. Eisdorfer (2007). "Uncomplicated general anesthesia in the elderly results in cognitive decline: Does cognitive decline predict morbidity and mortality?". Medical Hypotheses 68 (3): 484-492. doi:10.1016/j.mehy.2006.08.030.
- ↑ Reinberg, Steven. "Anesthetic Linked to Alzheimer's Risk", HealthDay News, 15 January 2007. Retrieved on 2007-08-08.
External links
de:Isofluranit:Isofluranonl:IsofluraanAcknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
