Fluorinated epinephrines

Desflurane is less potent than the other fluorinated anesthetics having MAC values of 5.7 to 8.9% in animals (76,85), and 6% to 7.25% in surgical patients. The respiratory effects are similar to isoflurane. Heart rate is somewhat increased and blood pressure decreased with increasing concentrations. Cardiac output remains fairly stable. Desflurane does not sensitize the myocardium to epinephrine relative to isoflurane (86). EEG effects are similar to isoflurane and muscle relaxation is satisfactory (87). Desflurane is not metabolized to any significant extent (88,89) as levels of fluoride ion in the semm and urine are not increased even after prolonged exposure. Desflurane appears to offer advantages over sevoflurane and other inhaled anesthetics because of its limited solubiHty in blood and other tissues. It is the least metabolized of current agents. 

Like many organic solvents, including hexane, heptane, ben2ene, xylene, toluene, gasoline, and particularly some of the other chlorinated and fluorinated solvents, methylene chloride may cause cardiac arrhythmias in the presence of elevated epinephrine when inhaled at concentrations as high as 20,000 ppm (36). 

Ethylenimine Famphur Fluorine Fluoroacetanide Fluoroacetic acid, sodium salt Dithiopyrophosphoric acid, tetraethyl ester Endosulfan Endothall Endrin Epinephrine... 

The answer is 3 [IIC Tible 15-1]. The halocarbon compounds (e.g., chloroform, halothane, freon) and the fumes from overheated synthetic fluorine-containing resin-coated (Teflon) cookware are indirectly car-diotoxic because they sensitize the heart to sympathomimetic amines such as epinephrine. Following exposure to these substances, even the release of endogenous epinephrine associated with stress can pose a hazard. Yew plants contain a cardioactive alkaloid that inhibits depolarization and produces bradycardia and diastolic heart block. Furazolidone interferes with intermediary metabolism, resulting in a lack of energy arid a dilated, weak heart "round heart." Digitalis aflecTs potassium content in the cell. Monensin is an ionophore that alters the sodium-to-calcium ratio arid leads Id cardiac necrosis. 

Self-propelling aerosols of antiallergic, antibiotic, antitussive, or antianginal activities have been prepared using a fluorinated surfactant as the dispersant in Freon 114 and Freon 12 [203]. As an example, epinephrine bitartrate has been dispersed with perfluoro-n-octyl- -ethylsulfonamidoethyl phosphate. The use of fluorinated surfactants in intravascular oxygen carriers and blood substitutes is discussed in Chapter 10. 

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