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異氟醚

異氟醚
臨床資料
商品名英语Drug nomenclatureAerrane、Forane
AHFS/Drugs.comFDA专业药物信息
懷孕分級
  • C
给药途径吸入
ATC碼
识别信息
  • (RS)-2-氯-2-(二氟甲氧基)-1,1,1-三氟乙烷
CAS号26675-46-7  checkY
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard英语CompTox Chemicals Dashboard (EPA)
ECHA InfoCard100.043.528 編輯維基數據鏈接
化学信息
化学式C3H2ClF5O
摩尔质量184.5 g/mol
3D模型(JSmol英语JSmol
  • FC(F)(F)C(Cl)OC(F)F
  • InChI=1S/C3H2ClF5O/c4-1(3(7,8)9)10-2(5)6/h1-2H checkY
  • Key:PIWKPBJCKXDKJR-UHFFFAOYSA-N checkY

異氟醚或稱異氟烷(英語:Isoflurane,商品名Forane),是人畜常用的全身麻醉藥,可用於誘導或維持麻醉[1]。但受制於異氟醚對氣管的刺激性,一般會用其他藥物誘導麻醉[2][3]。異氟醚的給藥方式為吸入其蒸氣[1]

異氟醚的副作用包括抑制呼吸中樞、降低血壓及導致心律不齊[2]。更為嚴重的副作用包括恶性高热高血鉀症[1]。異氟醚不宜在本人或家族有惡性高熱病史的情況下使用[2]懷孕期間使用本藥對胎兒的安全性目前不明,但在剖腹生產的情況下使用相信是安全的[1][2]

異氟醚是鹵代醚麻醉藥家族的一員[4],在美國於1979年首次獲准臨床使用[1]。異氟醚是世界卫生组织基本药物标准清单中的藥品,是基礎醫療系統必備的藥品之一[5]。本藥在發展中國家售價約為每瓶(250毫升)17至170美元[6]

特性

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臨床用的異氟醚,瓶頸標識為紫色(左二)

作用機理

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和其他全身麻醉藥一樣,異氟醚的確實作用機理仍有待進一步探討[10]。異氟醚可以減低對痛楚的敏感度並鬆弛肌肉。本藥可與GABA受體谷氨酸受體甘氨酸受體ATP合成酶的亚单位D及NADH脫氫酶結合,但對每種蛋白質的作用各有不同。異氟醚能激活谷氨酸受體、甘氨酸受體及GABA受體的活動,而後兩者會導致運動功能壓抑[11]。相反,異氟醚對已打開的鉀離子通道的傳導有壓抑作用[12]

透過異氟醚施行的全身麻醉會減低血漿花生四烯酸乙醇胺(一種內源性大麻素)濃度。這也許和全身麻醉後壓力水平降低有關[13]

環境影響

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大氣當中的異氟醚的平均壽命約為3.2年,全球暖化潛勢為510(即二氧化碳的510倍),年排放量達到880公噸[14]

參見

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備註

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  1. ^ 40歲病人的情況下的體積分數
  2. ^ 正辛醇—水分配係數

參考文獻

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  1. ^ 1.0 1.1 1.2 1.3 1.4 Isoflurane - FDA prescribing information, side effects and uses. www.drugs.com. March 2015 [2016-12-13]. (原始内容存档于2016-12-21). 
  2. ^ 2.0 2.1 2.2 2.3 Isoflurane (inhalation anaesthetic) - Summary of Product Characteristics (SPC) - (eMC). www.medicines.org.uk. 2016-01-11 [2016-12-13]. (原始内容存档于2016-12-20). 
  3. ^ Kliegman, Robert M.; Stanton, Bonita M. D.; Geme, Joseph St; Schor, Nina F. Nelson Textbook of Pediatrics 20. Elsevier Health Sciences. 2015: 420 [2017-06-26]. ISBN 9780323263528. (原始内容存档于2016-12-20) (英语). 
  4. ^ Aglio, Linda S.; Lekowski, Robert W.; Urman, Richard D. Essential Clinical Anesthesia Review: Keywords, Questions and Answers for the Boards. Cambridge University Press. 2015: 115 [2017-06-26]. ISBN 9781107681309. (原始内容存档于2016-12-20) (英语). 
  5. ^ WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [2016-12-08]. (原始内容存档 (PDF)于2016-12-13). 
  6. ^ Isoflurane. International Drug Price Indicator Guide. [2016-12-08]. [永久失效連結]
  7. ^ 7.0 7.1 7.2 7.3 7.4 Record of Isofluran in the GESTIS Substance Database from the IFA英语Institute for Occupational Safety and Health.
  8. ^ Nickalls, R. W. D., & Mapleson, W. W. Age-related iso-MAC charts for isoflurane, sevoflurane, and desflurane in man. British Journal of Anaesthesia. August 2003, 91 (2): 170–4 [2017-06-26]. PMID 12878613. doi:10.1093/bja/aeg132. (原始内容存档于2013-04-15) (英语). 
  9. ^ Seto, T; Mashimo, T; Yoshiya, I; Kanashiro, M; Taniguchi, Y, The solubility of volatile anaesthetics in water at 25.0 degrees C using 19F NMR spectroscopy., J Pharm Biomed Anal, 1992, 10: 1–7, PMID 1391078 
  10. ^ How does anesthesia work?. Scientific American. 2005-02-07 [2017-06-26]. (原始内容存档于2016-05-29). 
  11. ^ Grasshoff, C.; Antkowiak, B. Effects of isoflurane and enflurane on GABAA and glycine receptors contribute equally to depressant actions on spinal ventral horn neurones in rats (PDF). British Journal of Anaesthesia. 2006-09-13, 97 (5): 687–694 [2017-06-28]. ISSN 0007-0912. doi:10.1093/bja/ael239. (原始内容存档 (PDF)于2017-09-10) (英语). 
  12. ^ Buljubasic, N.; Rusch, NJ.; Marijic, J; Kampine; ZJ, Bosnjak. Effects of halothane and isoflurane on calcium and potassium channel currents in canine coronary arterial cells. Anaesthesiology: 990–998. [2017-06-28]. PMID 1318010. (原始内容存档于2017-09-10) (英语). 
  13. ^ Weis, F.; Beiras-Fernandez, A.; Hauer, D.; Hornuss, C.; Sodian, R.; Kreth, S.; Briegel, J.; Schelling, G. Effect of anaesthesia and cardiopulmonary bypass on blood endocannabinoid concentrations during cardiac surgery. British Journal of Anaesthesia. 2010-08-01, 105 (2): 139–144 [2017-06-26]. ISSN 0007-0912. PMID 20525978. doi:10.1093/bja/aeq117. (原始内容存档于2021-08-28) (英语). 
  14. ^ Martin K. Vollmer; Tae Siek Rhee; Matt Rigby; Doris Hofstetter; Matthias Hill; Fabian Schoenenberger; Stefan Reimann. Modern inhalation anesthetics: Potent greenhouse gases in the global atmosphere. Geophysical Research Letters. 2015, 42 (5): 1606–1611. doi:10.1002/2014GL062785. 
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異氟醚
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