Isoflurane

Brand Names: Forane, Isoflurane (generic)

Drug Class: Inhalation anesthetic, halogenated ether

Overview

Isoflurane is a halogenated ether inhalation anesthetic used for induction and maintenance of general anesthesia. It provides rapid induction and recovery with minimal metabolism, making it suitable for various surgical procedures.

Mechanism of Action

Potentiates GABA-A receptor activity and inhibits excitatory neurotransmission, leading to CNS depression. It may also affect other ion channels and receptors.

Indications

  • Induction and maintenance of general anesthesia

Dosage

Induction: 1.5-3.0% with oxygen or oxygen/nitrous oxide mixture. Maintenance: 1.0-2.5% with oxygen or oxygen/nitrous oxide mixture. Adjust based on patient response and surgical requirements.

Contraindications

  • Known hypersensitivity to isoflurane or other halogenated agents
  • Malignant hyperthermia susceptibility
  • History of severe hepatic dysfunction following previous exposure

Side Effects

  • Hypotension
  • Respiratory depression
  • Nausea
  • Vomiting
  • Shivering
  • Malignant hyperthermia
  • Hepatitis
  • Cardiac arrhythmias
  • Cough
  • Laryngospasm

Interactions

  • Non-depolarizing muscle relaxants: Enhanced neuromuscular blockade
  • Opioids: Additive respiratory depression
  • Beta-blockers: Increased risk of bradycardia
  • MAO inhibitors: Potential for hypertensive crisis
  • Aminoglycosides: Enhanced neuromuscular blockade