Hypotension propanidid

Propanidid. Propanidid [1421-14-3] (Epontol), C gH2yNO, (7) a derivative of the propyl ester of homo vanillic acid, has been in clinical use in Europe for a number of years. Its main advantage is rapid onset of action and a fast recovery which, like etomidate, is because of rapid metaboHsm by esterases rather than redistribution (108). Excretion is rapid 75 to 90% of the dmg is eliminated as metaboUtes within two hours. Propanidid side effects include hypotension, tachycardia, and hyperventilation followed by apnea, as well as excitatory side effects such as tremor and involuntary muscle movement (109). 

Propanidid is a nonbarbiturate ultra-short-acting anesthetic agent that may cause hypotension and tachycardia. Unlike thiopental, which is redistributed, propanidid is metabolized rapidly by pseudocholinesterases. 

Many reports on allergy to Althesin (or perhaps to its solvent cremophor) have appeared, the most consistent symptoms being bronchospasm, hypotension and skin rash. Watt (50 ) administered Althesin to 3500 patients and found allergic reactions in 4 of them. AU these 4 patients had never experienced an allergic reaction before. Three of them had undergone a previous Althesin induction a few weeks earlier and the fourth had a propanidid induction. Unfortunately, no skin tests were performed in this latter case, as cremophor (which is also the solvent of propanidid) may have been responsible here. From this publication one must conclude that the incidence of aUergic reactions to Althesin is fairly high. More case reports on this matter have been published by Fisher (4 cases) and by Steel (1 case) (51C, 52C). 

Three groups of 50 patients were anaesthetized with diazepam 0.32 mg/kg, thiopentone 3.7 mg/kg or propanidid 4.6 mg/kg for elective cardioversion (54 ). Propanidid caused more hypotension and more excitatory side effects than did the other 2 drugs. In dogs, a marked myocardial depression following propanidid has been seen (55). 

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See also in sourсe #XX -- [ ]

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