Desflurane (inhalation route)

Desflurane is a medication that is utilized as a maintenance anesthesia after getting additional anesthetics prior to and throughout surgery; it is also utilized to trigger consciousness loss (general anesthesia) prior to and throughout surgery.

Overview

This medication must only be given by a trained physician, or with a doctor’s guidance. Desflurane is prescribed for children and adults; however, children under age six may experience additionally intensified side effects.

Desflurane is manufactured under the US brand name Suprane. It is available in both solution and liquid forms.

Conditions treated

• Surgery

Type of medicine

• General anesthetic

Side effects

Occasionally, patients may experience undesired side effects of the drug in addition to its necessary benefits. While it is not likely that all side effects will take place, if they do, they could require medical care. The most common reactions (with a rate of incidence of greater than 10%) that have an adverse reaction rate are vomiting, nausea, apnea, breath holding, and coughing.

If you do experience any of the subsequent side effects, be sure to consult with your physician right away.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common side effects (medical care required)

• Voice changes
• Throat soreness or dryness
• Swallowing difficulty
• Skin or lips blue-tinted
• Pains or body aches
• Nose running (drainage)
• Neck glands (swollen, tender)
• Lack of breathing
• Hoarseness
• Fever
• Congestion
• Chest tightness
• Breathing difficulty

Less common side effects (medical care required)

• Vision blurred
• Tiredness (atypical)
• Pulse irregularity, pounding, or quickness
• Nervousness
• Heartbeat irregularity, pounding, or quickness
• Heartbeat irregularity or slowness
• Headache
• Fainting, dizziness, or lightheadedness
• Ear pounding
• Dizzy tendencies
• Discomfort or pain within the chest

Rare side effects (medical care required)

• Vomiting and nausea
• Urine dark in color
• Upper right abdominal pain
• Sweating
• Stool discoloration (light-colored)
• Stomach pain
• Skin redness or flushing, specifically on the neck and face
• Skin and eyes yellowing
• Neck, back, jaw, or arms discomfort or pain
• Muscle stiffness or pains
• Muscle cramping or aching
• Moving difficulty
• Joints swelling
• Joint pain
• Heat or feelings of warmth
• General weakness and tiredness
• Breathing noisiness

Side effects - occurrence rate unknown (medical care required)

• Confusion
• Stomach pain
• Abdominal pain
• Urine decrease
• Dryness of the mouth
• Convulsions (sudden)
• Thirst increase
• Convulsions
• Urine decreased
• Mouth dryness
• Thirst increase
• Appetite loss
• No pulse or blood pressure
• Heart stopping
• Unconsciousness
• Heaviness or weakness of legs

In certain circumstances, side effects can occur, but they typically will not require medical care. As your body becomes more attuned to the medication, these particular side effects could diminish as the course of treatment progresses. Also, your medical care professional may be able to inform you of additional ways to either reduce or even possibly prevent some of the following side effects. Consult with your physician if you have questions regarding any of the subsequent side effects, if they continue, are prolonged, or become troublesome.

Less common side effects (medical care not required)

• White portion of the eyes red (unusual)
• Heightened mouth watering
• Eyelid redness (inside of)

Rare side effects (medical care not required)

• Shaking
• Restlessness
• Itching skin
• Irritability
• Hyperventilation
• Difficulty sleeping
• Anxiety

Side effects not included here could potentially happen for some patients. If other effects are noticed, please consult with your medical care professional.

Contact your physician for medical advice regarding side effects. The FDA also accepts reports of additional side effects; they can be contacted at 1-800-FDA-1088.

Dosage

This medication must be administered by a trained medical care professional in a medical facility, such as a hospital. This medication is given through a vaporizer and the patient then breathes it into their lungs through their mouth.

Medication will likely be given prior to the administration of desflurane.

Interactions

Drug interactions

While some medications never should be taken at or near the same time, other situations may warrant the need for two or more medications prescribed at the same time, despite the chances that an interaction will likely take place. Under these circumstances, your physician may be inclined to slightly adjust the dose, or they may decide to pursue additional precautions to protect you as a patient.

When on desflurane, it is imperative that you inform your physician if you are already prescribed any of the subsequent medications on the list below. The list below includes medications that would potentially have significant interactions, but this list is not all-inclusive.

It is not usually suggested to use desflurane with one or more of the following medications, however certain instances may require the combination. If your doctor decides to prescribe both medications simultaneously, your physician may choose to adjust the dosage or frequency for when and how often you are taking one or more of the medications.

• St John's wort
• Nitrous oxide
• Hydromorphone
• Cisatracurium

Other interactions

Some medications should never be taken at or near mealtime, due to the potential kinds of food interactions that can take place. The use of tobacco or alcohol (even sparingly) could cause a dangerous interaction for patients taking desflurane. Please be sure to consult with your physician about how medications are impacted by tobacco, alcohol and food.

Other medical issues

Patients who have additional medical issues could experience impacts in the effectiveness of desflurane. Inform your physician if you’ve been experiencing other medical issues, specifically:

• Upper airway illness (recent) - likelihood of side effects could be increased
• Malignant hyperthermia (suspected or known) - patients with similar conditions should not use
• Liver disease (viral hepatitis, cirrhosis) – your physician may choose to prescribe a different anesthetic for patients who have these conditions
• Liver disease (severe or moderate) or history of
• High potassium levels within the blood (hyperkalemia)
• Heart disease
• Diseases that tend to trigger muscle weakness (or history of), such as Eaton-Lambert syndrome, myasthenia gravis, Duchenne muscular dystrophy or familial periodic paralysis
• Blood vessel disease
• Asthma

Warnings

Your condition must be monitored carefully after you have received this medication. Regular checkups will give your physician a chance to monitor whether or not this medication is working as it should. Urine or blood tests could be required to watch for undesired side effects. Pulmonary and cardiovascular changes should be monitored especially closely.

When choosing whether or not to take a certain medication, patients must compare the risks that may occur from taking the medication against the benefits it may provide. This is a choice you must make carefully with your physician. For this medication, patients must consider the following warnings:

Malignant hyperthermia could take place after patients are given this medication.

There is a rare chance that hyperkalemia could take place after this medication is received. Inform your physician immediately if you experience difficulty breathing; tingling or numbness in the legs, feet, or hands, vomiting or nausea, heartbeat irregularity or confusion after this medication is given.

Prior to having any medical tests, the physician who is in charge must be aware that you are already taking desflurane. Taking this medication could impact certain test results.

Patients who are heading home within 24 hours of having been given a general anesthetic should not operate heavy machinery, drive, or perform additional activities that could turn out to be dangerous if they are not completely alert for 24 hours after getting a general anesthetic. Certain patients may have to wait longer than 24 hours prior to driving. This is due to the tendency of general anesthetics to cause weakness, tiredness, or drowsiness for certain people after receiving anesthetics. General anesthetics can also trigger issues with general coordination and the ability people have to think straight.

For 24 hours, do not consume alcoholic beverages and do not take other types of CNS depressants (medications that tend to cause the nervous system to slow down, potentially triggering drowsiness) for a 24 hour period after having received this medication or another general anesthetic. Doing these things could negatively impact the anesthetic effects. CNS depressants include muscle relaxants, medicine for barbiturates or seizures, pain drugs or narcotics (prescription), sleeping medication, tranquilizers, sedatives, cold medication, allergy medication, hay fever medication and antihistamines.

Never take additional medications if your doctor has not approved them previously. This also refers to vitamin and herbal supplements, nonprescription medications, and of course prescription drugs.

Allergies

If you have previously had any allergic or atypical reactions to a medication, please inform your physician right away. Also, let them know if you have additional kinds of allergies, including to animals, preservatives, dyes and foods. For medications that are non-prescription, read the informational label that discloses the ingredients cautiously.

Specific demographic use

Pediatric

Research conducted to date has not discovered issues that are pediatric-specific and could potentially impact the effectiveness of desflurane for children. However, it is important to note that children who are six years old and under could experience additional undesired side effects, including difficulty breathing, tightness of the chest or coughing. Parents should take care when this medication is prescribed to young children, or should request an alternative drug.

Geriatric

Research conducted to date has not discovered issues that are geriatric-specific and could potentially impact the effectiveness of desflurane for the elderly. However, it is important to note that geriatric patients have a higher likelihood of experiencing undesired effects, and they may benefit from a dose adjustment.

Pregnancy

This medication is a relaxant for the uterus. Research conducted to date has not discovered issues that could cause harm to a fetus, although there has not been adequate research conducted in pregnant women or an adverse effect has been demonstrated, but similar research in pregnant women has not identified a potential danger for the fetus.

Breastfeeding

Research conducted to date has not identified issues that could cause harm to the infant when a mother is taking this medication while breastfeeding. Breastfeeding mothers should compare the potential risks against the possible benefits prior to taking this drug.

Storage

As this medication must be administered in a medical facility, your medical care professional will ensure that this medication is stored according to the optimal storage conditions.

Summary

Desflurane is an inhalant that effectively allows patients to become unconscious without pain prior to surgery. Patients must be monitored carefully after this inhalant, especially pulmonary and cardiovascular shifts.