Drug interactions with inhalational anaesthetics. 1993

L Q Christensen, and J Bonde, and J P Kampmann
Department of Infectious Diseases M, Rigshospitalet, University of Copenhagen, Denmark.

The literature concerning the interactions between volatile anaesthetics, nitrous oxide and other compounds is reviewed. The majority are well known and most can be managed by careful dosage of the anaesthetics. The following interactions should be stressed since these are less predictable or potentially fatal. Of the cardiovascular drugs mainly the Ca++ channel blockers require attention. The volatile anaesthetics act synergistically with these drugs on the inhibition of cardiac conduction and may induce cardiac arrest. Aminoglycoside therapy should prompt an alternative to enflurane because of increased nephrotoxicity with this combination. Thiopentone induction makes the dog heart more susceptible to arrhythmias, especially during anaesthesia with volatile anaesthetics. Probably pentobarbitone, etomidate or a benzodiazepine should be preferred as an alternative to thiopentone when the use of adrenergic drugs peroperatively is anticipated. Nitrous oxide augments the sequelae after coronary air emboli and impaired cerebral perfusion in animals. The necessity of this drug should therefore be considered when anaesthetizing patients undergoing open heart surgery and patients with severe carotid or cerebral arteriosclerosis.

UI MeSH Term Description Entries
D004336 Drug Antagonism Phenomena and pharmaceutics of compounds that inhibit the function of agonists (DRUG AGONISM) and inverse agonists (DRUG INVERSE AGONISM) for a specific receptor. On their own, antagonists produce no effect by themselves to a receptor, and are said to have neither intrinsic activity nor efficacy. Antagonism, Drug,Antagonisms, Drug,Drug Antagonisms
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D004357 Drug Synergism The action of a drug in promoting or enhancing the effectiveness of another drug. Drug Potentiation,Drug Augmentation,Augmentation, Drug,Augmentations, Drug,Drug Augmentations,Drug Potentiations,Drug Synergisms,Potentiation, Drug,Potentiations, Drug,Synergism, Drug,Synergisms, Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000769 Anesthesia, Inhalation Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract. Insufflation Anesthesia,Anesthesia, Insufflation,Inhalation Anesthesia
D000777 Anesthetics Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic

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