Methoxyflurane interaction

Minocycline (Solodyn) [Antibiotic/Tetracycline] Uses Acne Action Tetracycline, bactmostatic Dose Adults Peds >12 y. 1 mg/kg PO daily X 12wk w/ food to -1- irritation Caution [C, ] assoc w/ pseudomembranous colitis w/ renal impair Contra AU gy, women of childbearing potential Disp Tabs SE D, HA, fevCT, rash, joint pain, fatigue, dizziness Interactions t Effects OF digoxin, oral anticoagulants t risk of n hrotox W/ methoxyflurane X effects W/... 

At this point an interesting observation can be made. Fluorine atoms are put into anesthetics in order to make the molecules more inert. Instead of entering chemical reactions such molecules cmly participate in intermolecular associations in the ceil membrane, a condition for being used as anesthetics. The most potent anesthetics, however, usually contain a last" hydrogen, often referred to as the acidic hydrogen. Chloroform, halothane, methoxyflurane are in this category. Molecules containing this C H bond are, of course, ejq>ected to enter polar interactions. 

In patients taking oral or parenteral tetracyclines who undergo methoxyflurane anesthesia, renal insufficiency and oxalate crystal formation in renal tissue was attributed to an interaction between these drugs (185-187). Tetracyclines are therefore not recommended preoperatively. 

Clinically important, potentially hazardous interactions with aminoglycosides, clindamycin, cyclopropane, enflurane, halothane, isoflurane, methoxyflurane, piperacillin, rocuronium... 

Clinically important, potentially hazardous interactions with amoxicillin, ampicillin, antacids, bacampicillin, calcium carbonate, carbenicillin, cloxacillin, digoxin, methotrexate, methoxyflurane, mezlocillin, nafcillin, oxacillin, penicillins, piperacillin, ticarcillin, zinc... 

Clinically important, potentially hazardous interactions with adefovir, aldesleukin, aminoglycosides, atracurium, bumetanide, carbenicillin, cephalexin, cephalothin, doxacurium, ethacrynic acid, furosemide, methoxyflurane, non-polarizing muscle relaxants, pancuronium, pipecuronium, polypeptide antibiotics, rocuronium, succinylcholine, teicoplanin, torsemide, tubocurarine, vecuronium... 

Clinically important, potentially hazardous interactions with acitretin, aluminum hydroxide, amoxicillin, ampicillin, antacids, bacampicillin, betamethasone, bismuth, bromelain, calcium, carbenicillin, cholestyramine, doxacillin, corticosteroids, dairy products, dicloxacillin, didanosine, digoxin, food, glidazide, iron, isotretinoin, methicillin, methotrexate, methoxyflurane, mezlocillin, nafcillin, oxacillin, penicillins, piperacillin, retinoids, rocuronium, strontium ranelate, sucralfate, ticarcillin, vitamin A, zinc... 

That the lipid solubility versus anesthetic potency relationship is not above criticism has been intimated for a number of years by a number of authors. Summaries of the relevant facts and comments are found in the reviews of Halsey and Kaufman . It is only since 1974, however, that the possible importance of polar interactions has become a target of intense discussions. General anesthetics have widely different chemical structures and it has never been possible to classify them on chemical grounds. Xenon, nitrous oxide, ethylene, cyclopropane, ether, chloroform, C Fg, SFg, CFj—CHClj, CFj-CHClBr (halothane), CHjOCF.CHCf, (methoxyflurane) can all exert anesthetic action. (This aspect will be discussed in more detail in the next section). Looking at the formulas of these different molecules it is hard to believe that they all associate with the same site and with the same type of forces. A series of observations have been made in recent years that substantiate this scepticism. 

Patients anaesthetised with inhalational anaesthetics (particularly cyclopropane and halothane, and to a lesser extent desflurane, enflurane, ether, isoflurane, methoxyflurane, and sevoflurane) can develop cardiac arrhythmias if they are given adrenaline (epinephrine) or noradrenaline (norepinephrine), unless the dosages are very low. Children appear to be less susceptible to this interaction. file addition of adrenaline to intrathecal tetracaine enhances the sedative effects of propofol. 

---