Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper presents a review on the pathological effects caused by acute or chronic exposure to the inhalation anesthetics halothane, methoxyflurane, or enflurane. Methoxyflurane has a dose-related nephrotoxicity due to its metabolic degradation with release of fluoride ions whereas suggested pathological renal effects of halothane or enflurane are still under discussion. As to the syndrome of halothane- (or enflurane-, methoxyflurane-) associated hepatitis no dose-dependent hepatotoxicity has been proven but interactions with hypoxia, hypotension, drug-pretreatment, and perhaps genetic abnormalities should be kept in mind. Severe hematologic alterations are effected by prolonged exposure to N2O or halothane and alterations of tumor immunity caused by anesthetic agents are reported, too. From clinical studies and observations of pregnant animals, a correlation between the incidence of miscarriages or malformations and chronic exposure to low doses of inhalation agents may be stated. Nevertheless, an inhalation agent is easy to control because it can be eliminated quickly in the case of complications. Therefore, one would not like to miss these inhalation agents in clinical practice but the immission into the operating room should be limited. Moreover, the best way to keep the operating room clean from waste anesthetic gases is the installation of a scavenging system which is connected to suction.
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PMID:[Adverse effects of modern inhalation anesthetics. 2. Control of amounts and elimination of escaping anesthesia gases]. 72 Oct 16

Methoxyflurane is utilized in obstetrics for analgesia during labor. It has been recognized as an unpredictable hepatotoxin. Although hepatitis has been seen after its use in anesthesia, only one case of hepatitis has been reported after its use for analgesia in labor. Two more cases of hepatitis following methoxyflurane analgesia are reported. Direct toxic effects of its metabolites and host idiosyncrasy may underlie the hepatic injury from methoxyflurane.
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PMID:Methoxyflurane hepatitis: two cases following obstetric analgesia. 613 1

Modern anaesthesia is said to have began with the successful demonstration of ether anaesthesia by William Morton in October 1846, even though anaesthesia with nitrous oxide had been used in dentistry 2 years before. Anaesthesia with ether, nitrous oxide and chloroform (introduced in 1847) rapidly became commonplace for surgery. Of these, only nitrous oxide remains in use today. All modern volatile anaesthetics, with the exception of halothane (a fluorinated alkane), are halogenated methyl ethyl ethers. Methyl ethyl ethers are more potent, stable and better anaesthetics than diethyl ethers. They all cause myocardial depression, most markedly halothane, while isoflurane and sevoflurane cause minimal cardiovascular depression. The halogenated ethers also depress the normal respiratory response to carbon dioxide and to hypoxia. Other adverse effects include hepatic and renal damage. Hepatitis occurs most frequently with halothane, although rare cases have been reported with the other agents. Liver damage is not caused by the anaesthetics themselves, but by reactive metabolites. Type I hepatitis occurs fairly commonly and takes the form of a minor disturbance of liver enzymes, which usually resolves without treatment. Type II, thought to be immune-mediated, is rare, unpredictable and results in a severe fulminant hepatitis with a high mortality. Renal damage is rare, and was most often associated with methoxyflurane because of excessive plasma fluoride concentrations resulting from its metabolism. Methoxyflurane was withdrawn from the market because of the high incidence of nephrotoxicity. Among the contemporary anaesthetics, the highest fluoride concentrations have been reported with sevoflurane, but there are no reports of renal dysfunction associated with its use. Recently there has been a renewed interest in xenon, one of the noble gases. Xenon has many of the properties of an ideal anaesthetic. The major factor limiting its more widespread is the high cost, about 2,000 times the cost of nitrous oxide.
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PMID:Inhalation anaesthesia: from diethyl ether to xenon. 1817 89