Isoflurane


Generic Medicine Info
Contraindications
Known or suspected genetic susceptibility to malignant hyperthermia (e.g. presence of RYR1 or CACNA1S pathogenic variants); history of confirmed hepatitis due to halogenated inhalational anaesthetic or unexplained moderate to severe hepatic dysfunction (e.g. jaundice associated with fever, leucocytosis, and/or eosinophilia) after previous isoflurane or other halogenated inhalational anaesthetic use.
Special Precautions
Patient with hypovolaemia, hypotension, heart failure, coronary artery disease, subendocardial ischaemia; increased intracranial pressure, mitochondrial disorders, myasthenia gravis, neuromuscular disease (e.g. Duchenne muscular dystrophy); who are haemodynamically compromised; at risk of QT prolongation (e.g. congenital long QT syndrome) or bronchoconstriction. Debilitated patients. Elderly. Pregnancy and lactation. Patient Counselling This drug may impair your mental alertness for some time after administration, if affected, do not drive or operate machinery. Monitoring Parameters Monitor ECG, heart rate and rhythm, blood pressure, serum K, oxygen saturation, end-tidal CO2 and isoflurane levels prior to and throughout anaesthesia.
Adverse Reactions
Significant: Respiratory depression, CV effects (e.g. QT prolongation, cardiac steal, reflex tachycardia), hypotension, hepatic effects (e.g. mildly increased liver enzymes, hepatitis with or without jaundice, sensitivity hepatitis), decreased renal, hepatic and splenic blood flow; markedly increased cerebral blood flow (at deeper levels), increased intracranial pressure, bronchospasm, laryngospasm; hypersensitivity reactions (e.g. anaphylaxis). Cardiac disorders: Ventricular, nodal or atrial arrhythmia. Gastrointestinal disorders: Nausea, vomiting, retching. General disorders and administration site conditions: Chills, ataxia, asthenia, fatigue. Investigations: Increased WBC count, blood glucose, and serum creatinine; decreased BUN. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Agitation, dizziness, drowsiness, headache. Psychiatric disorders: Delirium, mood changes, nightmare, confusional state, nervousness. Respiratory, thoracic and mediastinal disorders: Breath holding, cough, dyspnoea. Skin and subcutaneous tissue disorders: Diaphoresis.
Potentially Fatal: Malignant hyperthermia. Rarely, severe postoperative hepatic dysfunction (e.g. hepatic necrosis and failure), torsades de pointes; perioperative hyperkalaemia resulting in cardiac arrhythmias (children).
Drug Interactions
May increase the risk of ventricular arrhythmia with β-sympathomimetic agents (e.g. isoprenaline), and α- and β-sympathomimetic agents (e.g. epinephrine, norepinephrine). May cause marked hypotension and additive negative inotropic effect with dihydropyridine Ca antagonists and β-blockers. Isoniazid may increase plasma fluoride concentration and potentiate hepatotoxic effects of isoflurane. Potentiated respiratory depressant effects with narcotics, opioids, benzodiazepines and other sedative agents. May increase the risk of haemodynamic instability during surgery with non-selective MAOIs. Markedly potentiates the action of all commonly used muscle relaxants (most profound with non-depolarising agents). Reduced minimum alveolar concentration (MAC) with nitrous oxide. May increase the risk of perioperative hypertension with indirect-acting sympathomimetics (e.g. amphetamines, psychostimulants, appetite suppressants, ephedrine). May cause carboxyhaemoglobinaemia with desiccated CO2 absorbents in anaesthetic circle breathing systems.
ATC Classification
N01AB06 - isoflurane ; Belongs to the class of halogenated hydrocarbons. Used as general anesthetics.
Disclaimer: This information is independently developed by CIMS based on isoflurane 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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