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INDICATIONS : ISOFLURANE

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ISOFLURANE

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- WIKIPEDIA

- WIKIPEDIA

A major advantage of isoflurane is that the patent covering its use has expired, therefore it is very economical to use.

Anesthesia gases used globally contribute the equivalent of 1 million cars to global warming. Isoflurane is a greenhouse gas, with a global warming potential of 1401. One tonne of sevoflurane emitted is equivalent to 1401 tonnes of carbon dioxide in the atmosphere. Taking into account the different amounts typically used in 1 hour of anesthesia (1 minimal alveolar concentration-hour), isoflurane causes 2.2 times the global warming of sevoflurane, but is much less damaging than desflurane, which causes 26.8 times the damage.
Isoflurane 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 name comes from being a structural isomer of enflurane, hence they have the same empirical formula. It is a racemic mixture of (R) and (S) optical isomers. Its use in human medicine is now starting to decline, being replaced with sevoflurane, desflurane and the intravenous anesthetic 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 imply 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 nonflammable.
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 effects of NMDA. It activates calcium ATPase through an increase in membrane fluidity, and binds to the D subunit of ATP synthase and NADH dehydrogenase.

ISOFLURANE

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Medications Used in General Anesthesia:
Propofol, Vecuronium bromide, pancuronium, Halothane, Enflurane, Isoflurane, Midazolam, Ketamine, Nitrous Oxide, Thiopental, Etomidate, Atracurium

Regional Anesthesia:
Mepivacaine, Chloroprocaine, Lidocaine

Local Anesthesia:
Procaine, Lidocaine, Tetracaine, Bupivacaine

Topical Anesthesia:
Benzocaine, Lidocaine, Dibucaine, Pramoxine, Butamben, Tetracaine (Sprays, Ointments, Creams, Gels)