Fluorothane (Phtorothanum)

Composition

1,1,1-Trifluoro-2-chloro-2-bromoethanol.
Colorless, transparent, mobile, easily volatile liquid with an odor reminiscent of chloroform, sweet and burning taste. Density 1.865 - 1.870. Boiling point (distillation) + 49 - 51 C °. Slightly soluble in water (0.345%), miscible with anhydrous alcohol,
ether, chloroform, trichlorethylene, oils. Partition coefficient oil/water 330. Vapor pressure at +20°C
equal to 241.5 mm Hg. Art. Fluorotan does not burn and does not ignite. Under the action of light, halothane slowly decomposes.

pharmachologic effect

A powerful narcotic for inhalation anesthesia.
Pharmacokinetically, halothane is easily absorbed from respiratory tract and rapid release by the lungs unchanged; only a small part of halothane is metabolized in the body. The drug has a rapid narcotic effect, which stops shortly after the end of inhalation.
Vapors of halothane do not cause irritation of mucous membranes. There are no significant changes in gas exchange during anesthesia with halothane; arterial pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and the expansion of the peripheral vessels. Tone vagus nerve remains high, which creates conditions for bradycardia. To some extent, halothane has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines: the introduction of adrenaline and norepinephrine during anesthesia can cause ventricular fibrillation. Fluorotan does not affect kidney function.

Indications for use

Fluorotan is a powerful narcotic, which allows it to be used alone (with oxygen or air) to achieve the surgical stage of anesthesia or as a component of combined anesthesia in combination with other drugs, mainly nitrous oxide.
Under halothane anesthesia, various surgical interventions can be performed, including on the organs of the abdominal and thoracic cavities,
in children and the elderly. Non-flammability makes it possible to use it when using electrical and X-ray equipment during surgery.
Fluorotan is convenient for use during operations on the organs of the chest cavity, as it does not cause irritation of the mucous membranes of the respiratory tract, inhibits secretion, relaxes the respiratory muscles, which facilitates artificial ventilation lungs. Fluorothane anesthesia can be used in patients bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (neurosurgery, ophthalmic surgery, etc.).

Mode of application

For introduction into anesthesia, they begin with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then within 1.5 - 3 min increase it to 3-4 vol. %. To maintain the surgical stage of anesthesia, a concentration of 0.5 - 2 vol. %.
When using halothane, consciousness usually turns off 1-2 minutes after the start of inhalation of its vapors. After 3-5 minutes, the surgical stage of anesthesia begins. After 3-5 minutes after stopping the supply of halothane, the patients begin to wake up. Anesthetized depression completely disappears in 5-10 minutes after short-term and 30-40 minutes after prolonged anesthesia. Excitation is observed rarely and is poorly expressed.
During anesthesia with halothane, the supply of its vapors should be precisely and smoothly regulated. It is necessary to take into account the rapid change of stages of anesthesia. Therefore, halothane anesthesia is carried out using special evaporators located outside the circulation system. The concentration of oxygen in the inhaled mixture must be at least 50%. For short-term operations, halothane is sometimes also used with a conventional anesthesia mask. When applying halothane to the mask in the amount of 30-40 drops per minute, the excitation period lasts about 1 minute, and the surgical stage of anesthesia usually occurs at 3-5 minutes. As a rule, they start with the supply of halothane to the mask at a rate of 5-15 drops per minute, then the supply is quickly increased to 30-50 drops per minute; to maintain the surgical stage of anesthesia, 10-25 drops per minute are applied. It is not recommended to use halothane through a mask in children.
To avoid side effects associated with excitation of the vagus nerve (bradycardia, arrhythmia), atropine or metacin is administered to the patient before anesthesia. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less.
If it is necessary to enhance muscle relaxation, it is preferable to prescribe relaxants of a depolarizing type of action (ditilin); when applying
drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using
muscle relaxants (with controlled breathing) should not exceed 1 - 1.5 vol.%.
Ganglioblockers are prescribed in smaller doses, since their action is potentiated by halothane.

Side effects

During anesthesia with halothane, due to inhibition of sympathetic ganglia and expansion of peripheral vessels, increased bleeding is possible, which requires careful hemostasis, and, if necessary, compensation for blood loss.
Due to the rapid awakening after the cessation of anesthesia, patients may feel pain, so early use of analgesics is necessary.
Sometimes in postoperative period chills are observed (due to vasodilation and heat loss during surgery). In these cases, patients need to be warmed with heating pads. Nausea and vomiting usually do not occur, but the possibility of their occurrence in connection with the administration of analgesics (morphine) should be considered.
It should be borne in mind that people working with halothane may develop allergic reactions.

Contraindications

Anesthesia with halothane should not be used, with pheochromocytoma (adrenal gland tumors), severe hyperthyroidism (disease thyroid gland) and in other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism. It should be used with caution in patients with cardiac arrhythmias, hypotension, organic lesions liver. During gynecological operations, it should be borne in mind that halothane can cause a decrease in the tone of the muscles of the uterus and increased bleeding. The use of halothane in obstetrics and gynecology should be limited only to those cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.
When anesthesia with halothane, adrenaline and norepinephrine should not be used to avoid arrhythmias.

Release form

In well-corked orange glass bottles of 50 ml. Attention!
Description of the drug Fluorotan"on this page is a simplified and expanded version official instructions by application. Before purchasing or using the drug, you should consult your doctor and read the annotation approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use. Dosage form:  Liquid for inhalation. Composition: As an active ingredient- halothane;

excipient- thymol.

Description: Transparent, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform. Pharmacotherapeutic group:Means for inhalation general anesthesia ATX:  

N.01.A.B.01 Halothane

N.01.A.B Halogenated hydrocarbons

Pharmacodynamics:Causes a rapid introduction to anesthesia with no or minimal manifestation of the excitation stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore it is required additional application muscle relaxants). Increases the tone of n.vagus, causes bradycardia. Due to the direct negative inotropic action, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. In proportion to the depth of general anesthesia weakens the contractility of the uterus. At a concentration of 0.5 to 3-4 vol.%, the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes. Pharmacokinetics:When inhaled, it is absorbed from the lumen of the alveoli into the bloodstream, the concentration in the alveoli and blood quickly balances. It is distributed in organs with good vascularization (brain, heart, liver), muscles, adipose tissue. Quickly passes histohematic barriers, including blood-brain and placental. After the cessation of entry into the body, the decrease in its concentration in plasma is exponential. It is excreted by the lungs - 60 and 80% unchanged; kidneys - 20% in the form of inactive metabolites.

It is metabolized by oxidation in the liver, the main metabolites are trifluoroacetic acid, chlorides, bromides. It is excreted mainly by the lungs unchanged and in the urine as metabolites. At low oxygen tension, it is metabolized to the free radical chlorotrifluoroethyl, which is able to react with the components of the hepatocyte membrane.

Indications: Introductory and maintenance anesthesia in adults and children. Contraindications:Hypersensitivity, unexplained jaundice, fever or fever after administration of halothane in history; pheochromocytoma, hypercatecholaminemia, arterial hypotension, myasthenia gravis, the use of halothane for general anesthesia less than 3 months ago, pregnancy (1 trimester), the period of childbirth and the early postpartum period, dental procedures for children and adolescents under 18 years of age outside hospital conditions. Carefully:Reception of cardiac glycosides. The drug is contraindicated in patients with a known or suspected genetic predisposition to malignant hyperthermia. Pregnancy and lactation:Contraindicated in the 1st trimester of pregnancy, during childbirth and in early postpartum period. After anesthesia, the drug should be discontinued breast-feeding for 24 hours. Dosage and administration:

Suitable for any type of inhalation anesthesia. The correct dose is achieved using a calibration vaporizer located outside closed system circulation (to avoid overdose).

adults

Induction

For anesthesia at a flow rate of 8 l/min. start with the supply of halothane at a concentration of 0.5 vol.% (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 0.5 - 3 vol.%. As a maintenance concentration, as a rule, 0.5 - 1.5 vol.% is sufficient for adults.

Children

During induction, children, starting from newborns, require more concentration than adults.

Elderly

Elderly patients require a lower dosage of halothane, but the actual dose is based on the physical condition of the patient.

The surgical stage of anesthesia is usually reached in 4-6 minutes.

The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol.%, when mixed with nitrous oxide - 0.3 vol.%. MAC of halothane mixed with oxygen for children up to 6 months. - 1.08 vol.%; up to 10 years - 0.92 vol.%; for persons over 70 years old - 0.64 o6%.

At the end of the operation, the oxygen flow is increased for faster elimination of halothane and elimination of possible hypercapnia.

In order to avoid side effects associated with excitation of the vagus nerve (bradycardia, arrhythmia), the patient is administered before anesthesia or metacin. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less. If it is necessary to enhance muscle relaxation, it is preferable to prescribe relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled breathing) should not exceed 1 - 1.5 vol.%.

Side effects:From the side of the central nervous system: possible after waking up headache, tremor; increased intracranial pressure.

From the side of cardio-vascular system: arterial hypotension, bradycardia, disorders heart rate.

From the side digestive system: abnormal liver function up to the development of jaundice, hepatitis, liver necrosis, especially with repeated injections; after waking up, nausea, postoperative vomiting is possible Others: respiratory depression, increased intracranial pressure, eosinophilia, the development of malignant hyperthermia is possible. Malignant hyperthermia is a very severe, often fatal, complication of anesthesia, especially in children and adolescents. Clinically, this complication is manifested by severe tachycardia, a drop in blood pressure, impaired gas exchange, and a sharp increase in the child's body temperature up to 40-42 ° C. Malignant hyperthermia can quickly lead to cerebral edema and death.

The syndrome of malignant hyperthermia is usually observed in individuals with a hereditary predisposition to malignant hyperthermia. Body temperature quickly rises to 42 ° C (!) and above, generalized rhabdomyolysis occurs, and pronounced acidosis develops.

The possibility of developing malignant hyperthermia should be remembered in case of insufficient muscle relaxation at the beginning of anesthesia, as well as in the event of fasciculations in response to the administration of dithylin. In some patients, the first sign of muscle damage is trismus, which develops during intubation. Although the increase in temperature is the result of the contractile activity of the muscles, it can increase very quickly.

Overdose: Symptoms: severe bradycardia, arrhythmias, hypotension, hyperthermic crisis, depressed respiration.

Treatment: IVL with pure oxygen, symptomatic therapy.

Interaction: Sympathomimetics increase the risk of developing arrhythmias. It enhances the effect of non-depolarizing muscle relaxants, antihypertensive agents, bradycardia under the influence of digitalis preparations and cholinesterase inhibitors (neostigmine), weakens the effect of uterotonic agents. and derivatives of phenothiazines increase the depressant effect on the central nervous system.

Increases the risk of liver damage on the background of phenytoin. Aminoglycosides and polymyxins deepen neuromuscular blockade (may cause sleep apnea). increases the half-life, nitrous oxide, and phenothiazines - the power of general anesthesia. The likelihood of developing malignant hyperthermia increases suxamethonium, arrhythmias - xatin.

Enhances and prolongs the action and toxicity of tubocurarine chloride.

Ganglioblockers are prescribed in smaller doses, since their action is potentiated by halothane.

With the combination of oxytocin with halothane, arterial hypotension is possible, sinus bradycardia, pathological atrioventricular rhythm in the mother during childbirth.

In combination with MAO inhibitors, the risk of high blood pressure increases.

In addition, MAO inhibitors exacerbate toxic effect halothane. The use of beta-blocker timolol before surgery in the form eye drops during ftorotane anesthesia can cause hypotension and bradycardia.

Special instructions:Fluorotan has hepatotoxicity, as it is converted into free radicals in the liver, initiators of lipid peroxidation, and also forms metabolites (fluoroethanol), covalently binding to biomacromolecules. The frequency of hepatitis is 1 case per 10,000 anesthesia in adult patients. In children, liver damage develops much less frequently.

Causes muscle relaxation, so it should be used with caution in patients with myasthenia gravis and / or when used simultaneously with aminoglycoside antibiotics. During anesthesia, there may be an increase in blood flow in the vessels of the brain and / or an increase in intracranial pressure. These effects are usually more pronounced in the presence of intracranial neoplasms. To counteract these effects, moderate hyperventilation is used in neurosurgery.

There is a risk of developing unsystematic tachycardia in children.

Monitoring the patient's condition in anesthesia is carried out by monitoring the pulse, blood pressure (measured manually or automatically, by direct and indirect methods), continuous ECG recording, oxygen content in the blood (observing the color of the skin and mucous membranes, using a pulse oximeter or analysis blood), the temperature of the "core" and the surface of the body, the reaction of the pupils, the rate of diuresis, blood tests for gases, electrolyte composition and acid-base state.

Do not store in evaporators; before new use, the evaporator must be cleaned of halothane residues and its decomposition products. Thymol (used for stabilization) does not evaporate, remains in the evaporator, coloring the solution in a yellowish color, it is highly soluble, eliminated with ether. It is necessary to cancel levodopa 6-8 hours before the start of general anesthesia.

Patients with chronic alcoholism require large doses for anesthesia.

Influence on the ability to drive transport. cf. and fur.:

During the day after anesthesia, you should refrain from driving vehicles, machines and mechanisms.

Release form / dosage:Liquid for inhalation. Package: 50 ml in orange glass dropper bottles or brown glass bottles for medical preparations, packed with instructions for use in cardboard packs for consumer packaging in accordance with GOST 7933-89. Storage conditions:Store in a dry, dark place at temperatures up to 15 ° C

Fluorotan is used only in medical institutions.

Best before date: Shelf life 3 years. Do not use after the expiration date. Close Instructions

as an excipient.

Release form

Brown glass dropper bottles of 50 ml.

pharmachologic effect

Anesthetic .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Fluorotan is a powerful narcotic, therefore, to achieve the surgical stage of anesthesia, it is used alone in a mixture with oxygen. Its vapors mixed with oxygen are not explosive, which makes it possible to use electrical equipment during the operation. With combined anesthesia, it is combined with nitrous oxide or ether.

Fluorotan is 3 times stronger ether and 50 times nitrous oxide , the surgical stage of anesthesia occurs in 3-5 minutes. The stage of excitation is not expressed. Does not cause a feeling of suffocation, bronchospasm, does not irritate the mucous membranes, suppresses the cough reflex, vomiting rarely occurs. Provides good muscle relaxation, suppresses the secretion of glands (salivary, bronchial). Causes a reversible decrease in blood flow in the liver, diuresis and glomerular filtration, which depend on the dose. Awakening after anesthesia is fast - after 5 minutes. after discontinuation of anesthesia. Excitation is absent, post-narcotic depression is not expressed.

Under this type of anesthesia, surgical interventions are performed on the organs. abdominal cavity in children and the elderly. It is widely used in operations on the chest cavity, since it does not irritate the mucous membranes, inhibits secretion and relaxes the muscles involved in breathing. This facilitates the implementation of artificial ventilation of the lungs. This type of anesthesia is applicable in patients suffering from bronchial asthma . In neurosurgical and ophthalmosurgical operations, when it is necessary to avoid stress and excitation of the patient, its use is also indicated.

Of the negative effects, one can name the fact that the drug almost does not cause analgesia. In case of overdose, it weakens the contractility of the heart, causes bradycardia, hypotension, and even cardiac arrest. Increases the sensitivity of the heart muscle to catecholamines , in connection with which the application adrenaline and are contraindicated because arrhythmias and cardiac fibrillations may occur. Available in the postoperative period. Renders hepatotoxic effect due to the formation of toxic metabolites in the liver, it reduces the tone and contractility of the uterus. In clinical doses, it does not affect the function of the liver and kidneys. A special evaporator is used to avoid overdose Ftorotek , which allows you to accurately dose the drug.

Anesthesia caused by Fluorotan is strong, but it is a weak analgesic, therefore, after the cessation of anesthesia, pain is felt, which leads to the early use of analgesics. Rarely in the postoperative period, chills are noted, then patients need to be warmed with heating pads. Since Ftorotan inhibits the sympathetic ganglia and dilates the peripheral vessels, there is a risk of increased bleeding.

Pharmacokinetics

Easily absorbed from the respiratory tract. Poorly soluble in blood. The required concentration for operations is 12 mg, and at a concentration of 30–38 mg, the respiratory center is depressed. By adding nitrous oxide to the mixture, the concentration of Fluorothane can be reduced. Narcotic action quickly stops after the end of inhalation. About 80% of the drug is excreted through the lungs, and 20% is metabolized in the liver to the main metabolite - trifluoroacetic acid, the maximum concentration of which is observed a day after anesthesia. Within a week, metabolites are excreted in the urine.

Indications for use

The introduction and maintenance of anesthesia during surgical operations of various volumes and durations.

Contraindications

• I trimester of pregnancy;
• the period of childbirth;
• jaundice And hyperthermia after previous anesthesia with Fluorotan;
• liver disease ( hepatitis , );
• the need for adrenaline during the operation;
• period up to 3 months. after previous anesthesia halothane .

This type of anesthesia should not be used when pheochromocytoma (elevated content adrenaline), in patients with , in cardiac arrhythmias. The limitation of its use in obstetric and gynecological practice is due to the fact that Ftorotan causes a decrease in uterine tone and a tendency to bleeding.

Side effects

• tremor And hyperthermia after waking up;
• headache;
• liver dysfunction;
• nausea;
• jaundice , hepatitis (with repeated introduction);
• increased intracranial pressure;
• arterial hypotension ;
• bradycardia , ;
• cardiac arrhythmias.

Fluorotan, instructions for use (Method and dosage)

For induction anesthesia, Ftorotan 0.5 vol. % in a mixture with oxygen, then the concentration is increased to 3 - 4 vol. %. Support the surgical stage of anesthesia with a concentration of 0.5-2 vol. %. The oxygen concentration is maintained at 50%. It is also used as part of an azeotropic mixture: 2 parts of Fluorotan and 1 part of ether. Such a mixture has a more pronounced effect than ether, but weaker than Fluorotan. For short-term operations, a conventional anesthesia mask is used. If 30-40 drops of Fluorotan are given per minute, the surgical stage of anesthesia occurs at 5 minutes.

In order to avoid side effects (bradycardia, arrhythmia), or . Used to enhance muscle relaxation , while the concentration of Fluorotane should be no more than 1-1.5 vol. % with controlled breathing. Ganglioblockers are prescribed in smaller doses, since Ftorotan potentiates their action.

Overdose

Overdose manifests itself bradycardia , significant arterial hypotension , cardiac arrhythmias, and respiratory depression. The supply of Fluorotan to the respiratory mixture is stopped, mechanical ventilation is carried out with oxygen, and the function of the cardiovascular system is maintained.

Recipe (International)

Rp.: Phtorotani 250 ml.
D.t.d. N.1.
S. For inhalation anesthesia.

pharmachologic effect

Causes a rapid introduction to anesthesia with no or minimal manifestation of the excitation stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). Blocks sympathetic ganglia nervous system, dilates the arteries of the skin and muscles, lowers blood pressure. Increases the tone of n.vagus, causes bradycardia. Due to the direct negative inotropic action, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. Does not irritate the respiratory tract, does not cause an increase in the secretion of saliva and bronchial glands, has a moderate bronchodilating effect, inhibits cough and gag reflexes; in proportion to the depth of general anesthesia weakens the contractility of the uterus; does not cause acidosis. At a concentration of 0.5 to 3-4 vol.%, the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes.

Mode of application

For adults: Suitable for any type of inhalation anesthesia. The correct dosage is achieved with a calibration evaporator located outside the closed circulation system (to avoid overdosing).
If it is necessary to enhance muscle relaxation, it is preferable to prescribe muscle relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled ventilation of the lungs) should not exceed 1-1.5 vol. %.

Introduction to anesthesia begins with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 2-4 vol. %. The usual maintenance concentration is 0.5-2 vol. %. The concentration in the blood is 7-12 vol. % corresponds to the surgical stage of general anesthesia. The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol. %, when mixed with nitrous oxide - 0.3 vol. %. MAC of halothane mixed with oxygen for children up to 6 months. - 1.08 vol. %; up to 10 years -0.92 vol. %; for persons over 70 years old -0.64 vol. %. For premedication, it is preferable to use not morphine, but promedol, which excites the centers of the vagus nerve less.

When using halothane, consciousness usually turns off 1-2 minutes after the start of inhalation of its vapors. After 3-5 minutes, the surgical stage of anesthesia begins. After 3-5 minutes after stopping the supply of halothane, the patients begin to wake up. Anesthesia depression completely disappears in 5-10 minutes after short-term and 30-40 minutes after prolonged anesthesia. Excitation is observed rarely and is poorly expressed. Halothane vapors do not cause irritation of the mucous membranes of the respiratory tract, inhibit secretion, relax the respiratory muscles, which facilitates artificial ventilation of the lungs. There are no significant changes in gas exchange during anesthesia with halothane.

Arterial pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and with the expansion of peripheral vessels. The tone of the vagus nerve increases, and therefore bradycardia is possible. To some extent, halothane has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines; administration of epinephrine and norepinephrine during anesthesia can cause ventricular fibrillation

Indications

Inhalation general anesthesia for large and small surgical interventions, diagnostic procedures in various categories of patients (including those with chronic obstructive pulmonary disease, bronchial asthma and diabetes mellitus);

Fluorothane anesthesia is used in various surgical interventions, including on the organs of the abdominal and thoracic cavities, in children and the elderly with bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (in neurosurgery, ophthalmology, etc.).

Contraindications

Hypersensitivity to the drug;
- malignant hyperthermia (in history against the background of halothane);
- jaundice, liver disease;
- cranial hypertension;
- the need for local application of epinephrine in the surgical field (risk of arrhythmia);
- pheyochromocytoma;
- hyperthyroidism;
- hypercatecholaminemia;
- liver failure;
- arterial hypotension;
- arrhythmia;
- myasthenia gravis;
- increased intracranial pressure;
- use of halothane for general anesthesia less than 3 months ago;
- pregnancy (1 trimester), childbirth and early postpartum period.
Anesthesia with halothane should not be used in case of pheochromocytoma and in other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism.

Side effects

headache, tremor, intracranial hypertension, nausea;
- arterial hypotension, bradycardia, cardiac arrhythmias, arrhythmias;
- in some cases, liver dysfunction with the appearance of jaundice, hepatitis, liver necrosis is possible, especially with repeated injections;
- respiratory depression;
- in some cases, the development of malignant hyperthermia is possible.

After awakening, postanesthetic dimeritis is possible.
During gynecological operations, it should be borne in mind that halothane can cause a decrease in the tone of the uterine muscles and increased bleeding, so its use in obstetric and gynecological practice should be limited only to those cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.

Release form

Liquid for inhalation 50, 250 ml: fl. or bottle droppers 1, 20 or 64 pcs.
Liquid for inhalation is a clear, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform.
100 g - halothane 99.99 g
Excipients: thymol - 0.01 g.
50 ml - dark glass bottles (1) - packs of cardboard.
50 ml - dark glass dropper bottles (1) - packs of cardboard.
50 ml - dark glass bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass bottles (1) - cardboard packs (64) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (20) - cardboard boxes.
50 ml - dark glass dropper bottles (1) - cardboard packs (64) - cardboard boxes.

ATTENTION!

The information on the page you are viewing was created for informational purposes only and does not promote self-treatment in any way. The resource is intended to familiarize healthcare professionals with additional information about certain medicines, thereby increasing their level of professionalism. The use of the drug "" without fail provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of the medicine you have chosen.

INSTRUCTIONS for medical use medicinal product

FLUOROTANE

Tradename

Fluorotan

Dosage form

Liquid for inhalation

100 g of the preparation contain

Description

Pharmacological group

ATX code N01AB01

Pharmacological properties

Pharmacokinetics

Pharmacodynamics

Causes rapid induction into anesthesia with no or minimal arousal stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). It blocks the ganglia of the sympathetic nervous system, dilates the arteries of the skin and muscles, and lowers blood pressure. Increases the tone of n.vagus, causes bradycardia. Due to a direct negative inotropic effect, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. Does not irritate the respiratory tract, does not cause an increase in the secretion of saliva and bronchial glands, has a moderate bronchodilating effect, inhibits cough and gag reflexes; in proportion to the depth of general anesthesia, it weakens the contractility of the uterus; does not cause acidosis. At a concentration of 0.5 to 3-4% vol., the surgical stage of anesthesia is achieved in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes.

Indications for use

Dosage and administration

Introduction to anesthesia begins with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 2-4 vol. %. The usual maintenance concentration is 0.5-2 vol. %. The concentration in the blood is 7-12 vol. % corresponds to the surgical stage of general anesthesia. The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol. %, when mixed with nitrous oxide - 0.3 vol. %. MAC halothane admixture with oxygen for children up to 6 months. - 1.08 about. %; up to 10 years -0.92 vol. %; for persons over 70 years old - 0.64 vol. %. For premedication, it is preferable to use nemorphine, and promedol

Side effect

Respiratory depression

Contraindications

Jaundice, liver disease

Cranial hypertension

pheyochromocytoma,

Hyperthyroidism

Hypercatecholaminemia

Liver failure,

arterial hypotension,

Arrhythmia

myasthenia gravis

Drug Interactions

special instructions

arousal

Overdose

Release form and packaging

Storage conditions

Store in a dry, dark place at a temperature of 12-15 0С

Shelf life

Do not use after the expiration date!

Terms of dispensing from pharmacies

Used only in medical institutions

Manufacturer

Order of the Red Banner of Labor Open Joint Stock Company "Altaihimprom" named after. G.S. Vereshchagin (JSC "Altaihimprom"), Russia, 658837, Yarovoe, Altai Territory, Predzavodskaya square 2, tel / fax (38568)

INSTRUCTIONS

for medical use

medicinal product

FLUOROTANE

Tradename

Fluorotan

International non-proprietary name

Dosage form

Liquid for inhalation

100 g of the preparation contain

active substance - ftorotana 99.99 g

excipient - thymol 0.01g

Description

Transparent, colorless, heavy, mobile, volatile liquid with an odor reminiscent of chloroform.

Pharmacological group

General anesthetics. Halogenated hydrocarbons.

ATX code N01AB01

Pharmacological properties

Pharmacokinetics

When inhaled, it is absorbed from the lumen of the alveoli into the bloodstream, the concentration in the alveoli and blood quickly balances. It is distributed to organs with good vascularization (brain, heart, liver), muscles, and adipose tissue. Quickly passes histohematic barriers, including hematoencephalic and placental. After the cessation of entry into the body, the decrease in its plasma concentration is exponential. It is excreted by the lungs - 80% unchanged; kidneys - 20% in the form of inactive metabolites.

Pharmacodynamics

Causes rapid induction into anesthesia with no or minimal arousal stage. It has an analgesic and muscle relaxant effect (does not create sufficient relaxation of the muscles, and therefore additional use of muscle relaxants is required). It blocks the ganglia of the sympathetic nervous system, dilates the arteries of the skin and muscles, and lowers blood pressure. Increases the tone of n.vagus, causes bradycardia. Due to a direct negative inotropic effect, it reduces myocardial contractility and stroke volume. By increasing the sensitivity of cardiomyocytes to catecholamines, it increases the likelihood of developing arrhythmias. Does not irritate the respiratory tract, does not cause an increase in the secretion of saliva and bronchial glands, has a moderate bronchodilating effect, inhibits cough and gag reflexes; in proportion to the depth of general anesthesia, it weakens the contractility of the uterus; does not cause acidosis. At a concentration of 0.5 to 3-4% vol., the surgical stage of anesthesia is reached in 4-6 minutes, after the end of general anesthesia, awakening occurs in 5-15 minutes.

Indications for use

Inhalation general anesthesia for large and small surgical interventions, diagnostic procedures in various categories of patients (including those with chronic obstructive pulmonary disease, bronchial asthma and diabetes mellitus).

Fluorothane anesthesia is used for various surgical interventions, including on the organs of the abdominal and thoracic cavities, in children and the elderly with bronchial asthma. The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (in neurosurgery, ophthalmology, etc.).

Dosage and administration

Suitable for any type of inhalation anesthesia. The correct dosage is achieved with a calibration evaporator located outside the closed circulation system (to avoid overdosing). If necessary, to enhance muscle relaxation, it is preferable to prescribe muscle relaxants of a depolarizing type of action (ditilin); when using drugs of a non-depolarizing (competitive) type, the dose of the latter is reduced against the usual one. The concentration of halothane when using muscle relaxants (with controlled ventilation of the lungs) should not exceed 1-1.5 vol. %.

Introduction to anesthesia begins with the supply of halothane at a concentration of 0.5 vol. % (with oxygen), then gradually increase the concentration of halothane vapor in the mixture to 2-4 vol. %. The usual maintenance concentration is 0.5-2 vol. %. The concentration in the blood is 7-12 vol. % corresponds to the surgical stage of general anesthesia. The minimum alveolar concentration (MAC) for adults when mixed with oxygen is 0.77 vol. %, when mixed with nitrous oxide - 0.3 vol. %. MAC halothane admixture with oxygen for children up to 6 months. - 1.08 about. %; up to 10 years -0.92 vol. %; for persons over 70 years old - 0.64 vol. %. For premedication, it is preferable to use nemorphine, but promedol, which excites the centers of the vagus nerve less. When using halothane, consciousness usually turns off after 1-2 minutes after the start of inhalation of its vapors. After 3-5 minutes, the surgical stage of anesthesia begins. After 3-5 minutes after stopping the supply of halothane, the patients begin to wake up. Narcotic depression completely disappears in 5-10 minutes after short-term and 30-40 minutes after prolonged anesthesia. Excitation is observed rarely and is poorly expressed. Halothane vapors do not cause irritation of the mucous membranes of the respiratory tract, inhibit secretion, relax the respiratory muscles, which facilitates artificial ventilation of the lungs. There are no significant changes in gas exchange during anesthesia with halothane. Arterial pressure usually decreases, which is partly due to the inhibitory effect of the drug on the sympathetic ganglia and the expansion of peripheral vessels. The tone of the vagus nerve increases, and therefore bradycardia is possible. To some extent, fluorotan has a depriming effect on the myocardium. In addition, halothane increases the sensitivity of the myocardium to catecholamines; the introduction of epinephrine and norepinephrine during anesthesia can cause ventricular fibrillation.

Side effect

Headache, tremor, intracranial hypertension, nausea

Arterial hypotension, bradycardia, cardiac arrhythmias, arrhythmias

In some cases, liver dysfunction may occur with the appearance of jaundice, hepatitis, liver necrosis, especially with repeated injections.

Respiratory depression

In some cases, malignant hyperthermia may develop.

After awakening, postanesthetic dimeritis is possible.

During gynecological operations, it should be borne in mind that fluorotan can cause a decrease in the tone of the muscles of the uterus and increased bleeding, so its use in obstetric and gynecological practice should be limited only to cases where uterine relaxation is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.

Contraindications

Hypersensitivity to the drug

Malignant hyperthermia (history on the background of halothane)

Jaundice, liver disease

Cranial hypertension

The need for local application of epinephrine in the surgical field (risk of arrhythmia)

pheyochromocytoma,

Hyperthyroidism

Hypercatecholaminemia

Liver failure,

arterial hypotension,

Arrhythmia

myasthenia gravis

Increased intracranial pressure

Use of halothane for general anesthesia less than 3 months ago

Pregnancy (1st trimester), labor and early postpartum

Anesthesia with halothane should not be used in case of pheochromocytoma and other cases when the content of adrenaline in the blood is increased, with severe hyperthyroidism.

Drug Interactions

Sympathomimetics increase the risk of developing arrhythmias. It enhances the effect of non-depolarizing muscle relaxans, antihypertensive agents, bradycardia under the influence of digitalis preparations and cholinesterase inhibitors (neostigmine), weakens the effect of uterotonic agents. Morphine ifenothiazines increase the depressant effect on the central nervous system.

Increases the risk of liver damage against the background of phenytoin. Aminoglycosides, lincomycin and polymyxins deepen neuromuscular blockade (may cause apnea). Ketamine increases the half-life, methyldopa, nitrous oxide, morphine and phenothiazines increase the power of general anesthesia. The likelihood of developing malignant hyperthermia increases suxamethonium, arrhythmias - xatin.

special instructions

Do not store in evaporators; before new use, the evaporator must be cleaned of halothane residues and its decomposition products. Thymol (used for stabilization) does not evaporate, remains in the evaporator, coloring the solution yellowish, it is highly soluble, eliminated with ether. It is necessary to cancel levodopa 6-8 hours before the start of general anesthesia. Patients with chronic alcoholism require large doses for anesthesia.

Fluorotan is not usually contraindicated in breastfeeding.

In the elderly and senile age, the use of halothane should be limited.

Halothane should not be used during pregnancy (I trimester),

The use of ftorotane in obstetrics - gynecological practice should be limited only to those cases where the relaxation of the uterus is indicated. Under the influence of halothane, the sensitivity of the uterus to drugs that cause its contraction (ergot alkaloids, oxytocin) decreases.

When anesthesia with halothane, epinephrine and norepinephrine should not be used to avoid arrhythmias. It should be borne in mind that people working with fluorothane may develop allergic reactions.

Under halothane anesthesia, various surgical interventions can be performed, including on the organs of the abdominal and thoracic cavities, on children and the elderly. It is not recommended to use halothane through a mask in children.

The use of halothane is especially indicated in cases where it is necessary to avoid excitation and stress of the patient (neurosurgery, ophthalmic surgery, etc.).

Flammability makes possible application when used during the operation of electrical and X-ray equipment.

Overdose

Symptoms: severe bradycardia, arrhythmias, hypotension, hyperthermic crisis, depressed breathing.

Treatment: IVL with pure oxygen, symptomatic therapy.

Release form and packaging

50 ml in orange glass dropper bottles, sealed with a polyethylene stopper and a screw-on cap, or in brown glass bottles for packaging medicines, sealed with a plastic cap, with a Teflon gasket and a first opening control, supplied with the vials. A dropper bottle or a bottle, together with instructions for use in the state and Russian languages, is packed in cardboard packs.

Packs of 20 pieces or 64 pieces are packed in a cardboard box in accordance with GOST 7933-89 or corrugated cardboard in accordance with GOST 7376-89. Group packaging and shipping containers in accordance with GOST 17768-90.