Isoflurane Fahrenheit Adverse Reactions

Adverse reactions encountered in the administration of isoflurane are in general dose dependent extensions of pharmacophysiologic effects and include respiratory depression, hypotension and arrhythmias. Potential serious undesirable effects include malignant hyperthermia, hyperkalemia, elevated serum creatinine kinase, and myoglobinuria (see PRECAUTIONS).
Cardiac arrest, bradycardia, and tachycardia have been observed with general inhalation anesthetic drugs including isoflurane.
Reports of QT prolongation, associated with torsade de pointes (in exceptional cases, fatal), have been received.
Bronchospasm and laryngospasm due to airway irritation have been reported with volatile anesthetics during inhalation.
Electroencephalographic changes and convulsions have been observed with isoflurane. lsoflurane potentiates the muscle relaxant effect of all muscle relaxants, most notably nondepolarizing muscle relaxants, an MAC (minimum alveolar concentration) is reduced by concomitant administration of N₂O in adults.
Isolated cases of increased carboxyhemoglobin have been reported with the use of fluorinated inhalation agents (i.e., desflurane, enflurane and isoflurane).
lsoflurane, like other inhalational agents, has relaxant effects on the uterus with the potential risk for uterine bleeding.
Shivering, nausea, vomiting, ileus, agitation, and delirium have been observed in the postoperative period.
Transient increases in blood bilirubin, blood glucose and serum creatinine with decrease in BUN, serum cholesterol and alkaline phosphatase have been observed. As with all other general anesthetics, transient elevations in white blood count have been observed even in the absence of surgical stress.
Reports demonstrate that isoflurane can produce hepatic injury ranging from mild transient increases of liver enzymes to fatal hepatic necrosis in very rare instances.
Rare reports of hypersensitivity (including dermatitis contact, rash, dyspnoea, wheezing, chest discomfort, swelling face, or anaphylactic reaction) have been received, especially in association with long-term occupational exposure to inhaled anesthetic agents, including isoflurane. These reactions have been confirmed by clinical testing (e.g., methacholine challenge). The etiology of anaphylactic reactions experienced during inhalational anesthetic exposure is, however, unclear because of the exposure to multiple concomitant drugs, many of which are known to cause such reactions.
Minimally raised levels of serum inorganic fluoride occur during and after isoflurane anesthesia, due to biodegradation of the agent. It is unlikely that the low levels of serum inorganic fluoride observed could cause renal toxicity, as these are well below the proposed threshold levels for kidney toxicity.