Enflurane

Overview

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.

Categories

Primary Characterstics

Indications

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Pharmacokinetics

Volume of distribution is found to be 8.6 l/ kg and plasma protien binding is 50-60%. and metabolism is reported Enflurane in metabolized by liver. Renal Excretion accounts for 90% through urine and plasma half life is 11hours.

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Contraindications

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Drug Interactions

Enflurane is known to interact with other drugs, the details of drug interactions is as follows:

Severity N/A

Alcuronium (Cl)

Interaction of Alcuronium (Cl) with Enflurane

Amitriptyline (HCl)

Interaction of Amitriptyline (HCl) with Enflurane

Doxapram

Interaction of Doxapram with Enflurane

Nitrous Oxide

Interaction of Nitrous Oxide with Enflurane

Naloxone (HCl)

Interaction of Naloxone (HCl) with Enflurane

Morphine

Interaction of Morphine with Enflurane

Lignocaine

Interaction of Lignocaine with Enflurane

Ketamine (HCl)

Interaction of Ketamine (HCl) with Enflurane

Alcohol

Interaction of Alcohol with Enflurane

Diazepam

Interaction of Diazepam with Enflurane

Amitriptyline (HCl)

Interaction of Amitriptyline (HCl) with Enflurane

Etomidate

Interaction of Etomidate with Enflurane

Isoproterenol

Interaction of Isoproterenol with Enflurane

Nitrous Oxide

Interaction of Nitrous Oxide with Enflurane

Sotalol (HCl)

Interaction of Sotalol (HCl) with Enflurane

Mivacurium (Cl)

Interaction of Mivacurium (Cl) with Enflurane

Diazoxide

Interaction of Diazoxide with Enflurane

Details: Enhanced hypotensive effect when Diazoxide given with Enflurane.
Methotrexate

Interaction of Methotrexate with Enflurane

Propofol

Interaction of Propofol with Enflurane

Details: Enflurane can be expected to increase the anesthetic or sedative and cardiorespiratory effects of Propofol Injectable Emulsion.

Moderate

Atracurium (Besylate)

Interaction of Atracurium (Besylate) with Enflurane

Details: Enflurane may increases the effect of atracurium.
Management: Atracurium dosage must be reduced.
Diltiazem (HCl)

Interaction of Diltiazem (HCl) with Enflurane

Details: Additive pharmacological actions are reported when enflurane giving with diltiazem.Effects include risk of cardiac depression,hypotension,cardiovascular collapse and ventricular impairment.
Management: Hemodynamic 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.
Isoniazid

Interaction of Isoniazid with Enflurane

Details: Metabolite of isoniazid, hydrazine, facilitates the defluorination of enflurane results in increased level of inorganic fluoride in plasma leads to nephrotoxicity.
Management: Closely monitor the renal function prior to surgery.
Pancuronium (Br)

Interaction of Pancuronium (Br) with Enflurane

Details: Enflurane potentiate the effects of pancuronium.
Management: Dose of pancuronium should be reduce if necessary.
Vecuronium (Br)

Interaction of Vecuronium (Br) with Enflurane

Details: Enflurane potentiates the effect of vecuronium.
Management: Dose of vecuronium should be reduced. Only specially trained health care providers should administer enflurane.
Doxacurium

Interaction of Doxacurium with Enflurane

Details: Enflurane may initiate non depolarizing muscle relaxant effect.
Management: Enflurane dosage must be adjusted and administered by specially trained anesthologist.

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.

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Side Effects

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Dosage

Enflurane's dosage details are as follows:
Dose Single Dose Frequency Route Instructions

Adult Dosage

0.5 to 3 %1.8 (1.75)As recommended.InhalationMaintenance, As Required for Anaesthesia induction
2 to 4.5 %3.2 (3.25)As recommended.InhalationInitially as Required

Paedriatic Dosage (20kg)

No data regarding the Paedriatic dosage details of Enflurane is available.

Neonatal Dosage (3kg)

No data regarding the neonatal dosage details of Enflurane is available.

High Risk Groups

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Warning / Precautions

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Storage Conditions

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Interference in Pathology

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Brands / Trade Names of Enflurane

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Manufacturers of Enflurane in Pakistan

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