Enflurane

Enflurane Uses, Dosage, Side Effects, Mechanism of Action, How Long Does it Take to Work? Enflurane is a brand name. Its generic name is Enflurane.

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Enflurane Introduction

Enflurane (also known as Ethrane) is a halogenated anesthetic drug used for general or local anaesthesia. It is a volatile, colorless liquid and is one of the most potent halogenated anesthetic agents. It is a non-flammable, non-explosive and inhalational anesthetic that, when vaporized, has a sweet, pungent odor. Enflurane is classified as an inhalation anesthetic and is used during different types of surgical procedures.

Uses For

Enflurane is mainly used during surgery as an inhalation anesthetic for general anesthesia or local anesthesia. It is mostly used when surgery involves the chest and abdominal areas, due to its potent effects and intense pain relief. It may be used as the sole anesthetic, or in combination with other agents.

Mechanism Of Action

Enflurane reduces excitation in both neuronal cells and muscles cells. It does this by interacting with neuronal and muscle cell membranes, causing a decrease in electrical excitability. It binds to and modulates the chloride channels in cell membranes, and this increases the duration of time the neuron takes to reach equilibrium potential. It also increases and prolongs the time the channels remain closed, which reduces the amount of neurotransmitter released.

How Long Does It Take To Work

Enflurane usually takes between two and five minutes for the patient to become sedated. The amount of time it takes to become completely anesthetized depends on the patient and the dosage given.

Absorption

Inhaling Enflurane enables it to be rapidly absorbed into the bloodstream via the lungs. The rate of absorption is dependent on the concentration of the anesthetic gas.

Route Of Elimination

Enflurane is primarily eliminated through the lungs during exhalation. Most of it is also eliminated through metabolism in the liver, and traces are eliminated through metabolism in the kidney.

Dosage

Enflurane is supplied as an inhalational anesthetic liquid in sealed bottles or copper-colored cylinders, in concentrations ranging from 0.5% to 8%. The precise dosage is decided by the anesthesiologist on a case-by-case basis.

Administration

Enflurane is administrated as a volatile liquid or vapor during surgery through an inhalant administration system and/or an endotracheal tube. It should be administered by a trained individual, such as a physician with experience in administering general anesthesia.

Side Effects

The side effects of Enflurane include dizziness, drowsiness, visual disturbances, agitation, confusion, changes in blood pressure, and depressed ventilation. Other rare side effects include nausea, vomiting, headache, increased salivation, allergies, bradycardia, hypotension, and arrythmias.

Toxicity

Enflurane is considered a relatively safe anesthetic drug when administered by experienced clinicians, however, over-exposure to the drug can lead to toxicity. Symptoms of Enflurane toxicity include coughing, shortness of breath, increased body temperature, and tachycardia (rapid heart rate).

Precaution

When using Enflurane it is especially important to closely monitor the patient's vital signs and responses to the drug. Careful consideration should be given to the patient's age, pre-existing medical conditions, and the type and length of the surgery planned.

Interaction

Enflurane may interact with several other drugs, such as barbiturates, benzodiazepines, and anticholinergics. These interactions can increase the sedative effects of the drug. Additionally, alcohol and other CNS depressants may interact with Enflurane, enhancing the depressant effects on the CNS.

Disease Interaction

Patients with myasthenia gravis, respiratory depression, and other neuomuscular diseases may be more sensitive to the effects of Enflurane and may require reduced doses. Additionally, patients with hypothyroidism, renal, hepatic, and cardiovascular diseases may require special precautions when administering this drug.

Drug Interaction

When administered concomitantly with other drugs, Enflurane may interact with drugs such as morphine, neuromuscular blockers, general anesthetics, and other CNS depressants.

Food Interactions

There are no known food interactions with Enflurane.

Pregnancy Use

Enflurane should be used with caution in pregnant women. The use of Enflurane during the first and second trimesters of pregnancy is not recommended unless absolutely necessary. During the third trimester, Enflurane should only be administered when the benefits outweigh the potential risks to the fetus.

Lactation Use

Enflurane is excreted in the breast milk, so caution should be taken when using this drug in breastfeeding women.

Acute Overdose

An acute overdose of Enflurane can be life-threatening and can cause serious symptoms such as respiratory depression, hypotension, and central nervous system depression. Treatment of an acute overdose should include supportive therapies such as assisted ventilation, intravenous fluids, and resuscitation.

Contraindication

Enflurane is contraindicated in patients with hypersensitivity and/or severe bronchospasm, severe hepatic impairment, or in patients who have a history of malignant hyperthermia.

Use Direction

Enflurane should be administered as an inhalant general anesthetic only by experienced clinicians in a hospital setting. Careful titration of the dose is recommended as there is potential for rapid onset of general anesthesia with shallow titration.

Storage Condition

Enflurane should be stored in a cool, dry, well-ventilated area away from direct sunlight. Since it is a volatile liquid with a high vapor pressure, bottles should not be stored above room temperature. It should also be kept away from open flames and arcs, and stored in its original sealed bottles.

Volume Of Distribution

The volume of distribution of Enflurane is around 4-6 L/kg.

Half Life

The half life of Enflurane is around 4 hours in adults.

Clearance

The clearance of Enflurane is around 0.7 - 0.8 L/min/kg.

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