Desflurane (Desflurane)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Means for anesthesia

Included in the formulation
  • Supran
    liquid d / inhal. 
    Baxter Healthcare Corporation     Puerto Rico
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    АТХ:

    N.01.A.B   Halogenated hydrocarbons

    Pharmacodynamics:

    The drug is fluorine-halogenated methyl ether, when inhaled, causes a dose-dependent loss of pain sensitivity and consciousness, suppresses motor activity, depresses the respiratory system, reduces vegetative reflexes, inhibits the cardiovascular system.

    The mechanism of action of funds for inhalation anesthesia is not completely clear. It is known that the drugs of this group lower the spontaneous and induced activity of neurons of different regions of the brain. Means for anesthesia stimulate or increase the sensitivity to gamma-iminobutyric acid and glycine of the corresponding receptors in the brain and spinal cord, as well as inhibit the activity of glutamate receptors, in particular NMDA receptors (NDMA-N-methyl-D-aspartate). The majority means for anesthesia are defined binding sites with these receptors. Along with this, it is believed that the means for inhalation anesthesia may reduce the release of certain mediators (acetylcholine, dopamine, serotonin, noradrenaline) in the brain.

    Pharmacokinetics:

    Rapid introduction to general anesthesia and rapid recovery from general anesthesia, flexibility in controlling the depth of anesthesia.

    Solubility in the blood is low, rapidly excreted from the body by the lungs, is metabolized minimally (0.02%).

    Indications:

    As an inhalant for introductory and / or maintenance anesthesia in adults, as well as for maintaining anesthesia in children during surgical interventions in inpatient and outpatient settings.

    ICD-10

    XXI.Z40-Z54.Z51.4   Preparatory procedures for subsequent treatment, not elsewhere classified

    Contraindications:

    Hypersensitivity; PContraindications to general anesthesia; genetic predisposition to malignant hyperthermia (presumed or established); risk of coronary heart disease, and also when an increase in the heart rate / blood pressure is undesirable; conducting an introductory anesthesia in children under the age of 12 (since often there is coughing, holding the breath, apnea, laryngospasm and increased secretion); age of up to 6 years (unless intubation is used); lactation.

    Carefully:

    With repeated anesthesia with a small interval, pregnancy.

    Pregnancy and lactation:

    Category Food and Drug Administration (US Food and Drug Administration) - B. Due to the lack of appropriate and well-controlled studies involving pregnant women desflurane not shown for use in pregnancy. If, for vital reasons, there is a need to use desflurane during pregnancy, it should be borne in mind that desflurane relaxes the smooth musculature of the uterus and, consequently, reduces the blood flow between the uterus and the placenta, so if the need arises, carefully weigh the expected benefit to the mother and the possible risk to the fetus.

    Since data on the excretion of desflurane with breast milk is not enough, desflurane is not indicated for use in nursing mothers.

    Dosing and Administration:

    Applied inhalation, the alveolar concentration should be selected by a specialist in accordance with the patient's age, clinical situation and indications.

    Side effects:

    On the part of the respiratory organs: coughing, holding the breath, apnea, hypoxia, bronchospasm, hemoptysis, pharyngitis, laryngospasm.

    On the part of the gastrointestinal tract: acute pancreatitis, vomiting, nausea, abdominal pain, increased salivation, cytolytic hepatitis, jaundice, cholestasis, necrotic hepatitis, liver function disorders.

    From the nervous system: anxiety, dizziness, headaches, convulsions.

    From the cardiovascular system: arrhythmia, cardiac arrest, myocardial ischemia, shock, hypertension, bleeding, vasodilation, bradycardia, arrhythmia such as pirouette, ventricular failure, tachycardia, increase / decrease in blood pressure, ventricular hypokinesia, malignant hypertension.

    From the musculoskeletal system: acute necrosis of skeletal muscles, myalgia.

    Laboratory and instrumental data: an increase in the activity of creatine phosphokinase, a decrease in the content of oxyhemoglobin in the blood <90%; deviation of the electrocardiogram.

    Other: hypokalemia, hyperkalemia, metabolic acidosis, coagulopathy, skin redness, icterus sclera, asthenia, urticaria, malaise.

    Overdose:

    Inhibition of respiration and cardiac activity. Treatment: cease introduction desflurane, support airway patency, oxygen therapy, maintenance of cardiovascular function system.

    Interaction:

    Joint reception with dinitrogen, fentanyl, midazolam reduce the minimum alveolar concentration of the drug.

    The drug enhances the effect of muscle relaxants, analgesics, sedatives.

    Special instructions:

    The drug should not be taken as the only drug for anesthesia.

    Impact on the ability to drive vehicles and manage mechanisms

    The drug affects the ability to drive vehicles, as well as perform work related to the need for concentration.

    Instructions
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