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| {{drugbox
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| | IUPAC_name = 2-chloro-2-(difluoromethoxy)-1,1,1-trifluoro-ethane
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| | image = Isoflurane2.png
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| | image2 = Isoflurane-3D-vdW.png
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| | CAS_number = 26675-46-7
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| | ATC_prefix = N01
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| | ATC_suffix = AB06
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| | ATC_supplemental =
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| | PubChem = 3763
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| | DrugBank = APRD00212
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| | C=3 | H=2 | Cl=1 | F=5 | O=1
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| | molecular_weight = 184.5 g/mol
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| | bioavailability =
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| | protein_bound =
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| | metabolism =
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| | elimination_half-life =
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| | pregnancy_category =
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| | legal_status =
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| | routes_of_administration =
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| }}
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| '''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 [[Diethyl ether|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]].
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| 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.
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| A major advantage of isoflurane is that the [[patent]] covering its use has expired, therefore it is very economical to use.
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| ==Physical properties==
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| {|
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| |[[Molecular weight]] ||align=right| 184.5g/mol ||
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| |-
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| |[[Boiling point]] (at 1 [[atmosphere (unit)|atm]]): ||align=right| 48.5 °C ||
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| |-
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| |[[Density]] (at 25 °C): ||align=right| 1.496 g/mL ||
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| |-
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| |[[Minimum alveolar concentration|MAC]] : ||align=right| 1.15 vol %||
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| |-
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| |[[Vapor pressure]]: ||align=right| 238 [[torr|mmHg]] ||align=right| 31.7 [[pascal (unit)|kPa]] || (at 20°C)
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| |-
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| | ||align=right|295 mmHg ||align=right| 39.3 kPa || (at 25°C)
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| |-
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| | ||align=right|367 mmHg ||align=right| 48.9 kPa || (at 30°C)
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| |-
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| | ||align=right|450 mmHg ||align=right| 60.0 kPa || (at 35°C)
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| |-
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| |Water [[Solubility]] ||align=right|Insoluble
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| |-
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| |Blood:Gas Partition coefficient: ||align=right|1.4
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| |-
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| |Oil:Gas Partition coefficient: ||align=right|98
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| |}
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| ==Mechanism of action==
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| 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 receptor]]s, [[glutamate receptor]]s and [[glycine receptor]]s, and also [[enzyme inhibitor|inhibits]] conduction in activated [[potassium channel]]s. 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.
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| ==Possible link to cognitive decline==
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| Isoflurane exposure has been shown to induce cognitive decline in mice.<ref>{{cite journal
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| | title=Brain and behavior changes in 12-month-old Tg2576 and nontransgenic mice exposed to anesthetics
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| | author= S. L. Bianchi, T. Tran, C. Liu, S. Lin, Y. Li, J. M. Keller, R. G. Eckenhoff, M. F. Eckenhoff
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| | journal=Neurobiology of Aging
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| | volume=28
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| | issue=in press
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| | pages=in press
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| | year=2007
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| | doi= 10.1016/j.neurobiolaging.2007.02.009
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| }}</ref> Exposure of cultured human cells to isoflurane has been reported to induce [[apoptosis]] and accumulation and aggregation of [[amyloid beta]] protein.<ref>{{cite journal
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| | title=The Inhalation Anesthetic Isoflurane Induces a Vicious Cycle of Apoptosis and Amyloid β-Protein Accumulation
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| | author= Z. Xie, Y. Dong, U. Maeda, R. D. Moir, W. Xia, D. J. Culley, G. Crosby, R. E. Tanzi
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| | journal=Journal of Neuroscience
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| | volume=27
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| | issue=6
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| | pages=1247-1254
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| | year=2007
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| | doi= 10.1523/JNEUROSCI.5320-06.2007
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| }}</ref> Further research will be required to establish whether or not clinical exposure to isoflurane leads to [[dementia]] ([[Alzheimer's disease]]).<ref>{{cite journal
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| | title=Uncomplicated general anesthesia in the elderly results in cognitive decline: Does cognitive decline predict morbidity and mortality?
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| | author= M. C. Lewis, I. Nevoa, M. A. Paniaguaa, A. Ben-Aric, E. Prettoa, S. Eisdorfera, E. Davidsona, I. Matotc, C. Eisdorfer
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| | journal=Medical Hypotheses
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| | volume=68
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| | issue=3
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| | pages=484-492
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| | year=2007
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| | doi= 10.1016/j.mehy.2006.08.030
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| }}</ref><ref>{{cite news
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| | url=http://www.healthfinder.gov/news/newsstory.asp?docID=600964
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| | title=Anesthetic Linked to Alzheimer's Risk
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| | date=15 January 2007
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| | publisher= HealthDay News
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| | accessdate=2007-08-08
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| | first=Steven
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| | last=Reinberg}}</ref>
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| ==References==
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| {{reflist|2}}
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| ==External links==
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| *[http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20F)/FORANE.html Rx Med]
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| {{General anesthetics}}
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| [[Category:Anesthetics]]
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| [[Category:Ethers]]
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| [[Category:Organohalides]]
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| [[Category:Organofluorides]]
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| [[de:Isofluran]]
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| [[fr:Isoflurane]]
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| [[it:Isoflurano]]
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| [[ja:イソフルラン]]
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| [[nl:Isofluraan]]
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| {{WikiDoc Sources}}
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