Desflurane


Generic Medicine Info
Contraindications
Known or suspected genetic susceptibility to malignant hyperthermia (e.g. presence of RYR1 or CACNA1S pathogenic variants); in whom general anaesthesia is contraindicated; risk factors for coronary artery disease, or where increases in heart rate or blood pressure are undesirable. History of moderate to severe hepatic impairment, or in whom liver dysfunction, jaundice or unexplained fever, leucocytosis or eosinophilia occurred after previous desflurane or other halogenated anaesthetic use. Induction of anaesthesia in children.
Special Precautions
Patient with underlying neuromuscular disease (e.g. Duchenne muscular dystrophy); risk factors for QT prolongation (e.g. congenital long QT syndrome, taking QT prolonging drugs); cirrhosis, viral hepatitis, or other pre-existing hepatic disease; intracranial space-occupying lesions; asthma or history of recent upper airway infection (particularly in children). Hypovolaemic, hypotensive, or debilitated patients. Not indicated for maintenance of anaesthesia in non-intubated children <6 years. Chronic renal and hepatic impairment. Children and elderly. Pregnancy and lactation. Patient Counselling This drug may impair your ability to perform some tasks for a certain period, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, heart rate and rhythm, temperature, oxygen saturation, end-tidal CO2 and end-tidal desflurane levels prior to and throughout procedure; renal function tests, urinary output, serum electrolytes and glucose (in diabetic patients) as necessary. Assess for signs and symptoms of malignant hyperthermia, hypercarbia, muscle rigidity, tachycardia, cyanosis, arrhythmias, and hypo- or hypertension; airway narrowing and adverse respiratory symptoms in children.
Adverse Reactions
Significant: Respiratory depression, disrupted hepatic function, icterus, sensitivity hepatitis (in patients previously sensitised with halogenated anaesthetic), decreased hepatic or renal blood flow, increased intracranial pressure, increased heart rate and blood pressure, hypotension. In children: postoperative agitation, adverse respiratory reactions (e.g. frequent cough, breath holding, apnoea, laryngospasm, increased secretions). Blood and lymphatic system disorders: Coagulopathy. Cardiac disorders: Nodal arrhythmia, bradycardia, tachycardia, dyspnoea, myocardial ischaemia. Eye disorders: Conjunctivitis, ocular icterus. Gastrointestinal disorders: Nausea, vomiting, abdominal pain, salivary hypersecretion. General disorders and administration site conditions: Asthenia, malaise, fever. Hepatobiliary disorders: Jaundice, cholestasis. Investigations: Increased creatine phosphokinase, abnormal ECG, transient elevations in WBC count and glucose. Metabolism and nutrition disorders: Hypokalaemia, metabolic acidosis. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Headache, dizziness, convulsions. Respiratory, thoracic and mediastinal disorders: Pharyngitis, hypoxia. Skin and subcutaneous tissue disorders: Erythema, pruritus, urticaria. Vascular disorders: Hypertension, vasodilation, haemorrhage.
Potentially Fatal: Malignant hyperthermia, torsade de pointes, liver necrosis. Rarely, perioperative hyperkalaemia resulting in cardiac arrhythmias in children.
Drug Interactions
Reduced minimum alveolar concentration (MAC) with nitrous oxide, opioids and benzodiazepines. May potentiate the effects of neuromuscular blocking agents (e.g. atracurium, pancuronium). May cause elevated carboxyhaemoglobin levels due to carbon monoxide production with desiccated CO2 absorbents. Increased risk of perioperative hyperkalaemia with suxamethonium.
ATC Classification
N01AB07 - desflurane ; Belongs to the class of halogenated hydrocarbons. Used as general anesthetics.
Disclaimer: This information is independently developed by CIMS based on desflurane from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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