Drug Reference for FDA Approved General Anesthetics @ Neurotransmitter.net
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Possible Mechanisms of Action: Because the other fluorinated volatile anesthetics enhance the effect of glycine at glycine receptors, desflurane is likely to share this mechanism of action. However, further experimentation is needed in order to clarify the matter. In addition, desflurane is likely to share another key property with other fluorinated anesthetics: the ability to inhibit the exchange of GTPγS for GDP bound to the nucleotide binding site of a subset of Gα proteins that may include Gαq (6). Indications: Desflurane is not recommended for induction of anesthesia in pediatric patients because of a high incidence of moderate to severe upper airway adverse events (see WARNINGS in the prescribing information). After induction of anesthesia with agents other than desflurane, and tracheal intubation, desflurane is indicated for maintenance of anesthesia in infants and children. |
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Possible Mechanisms of Action: At sub-anesthetic doses, enflurane inhibits the exchange of GTPγS for GDP bound to the nucleotide binding site of a subset of Gα (G alpha) proteins; these include Gαi2 > Gαi1 > Gαi3 > Gαs (15). Enflurane inhibits plasma membrane Ca2+-ATPase and sarcoplasmic reticulum Ca2+-ATPase (16). The drug may also increase the release of Ca2+ from sarcoplasmic reticulum Ca2+ release channels in muscle cells (17). Depending on the cell type considered, enflurane might inhibit T-type and L-type voltage-gated Ca2+ channels (18). The drug may inhibit the effect of GABA at rho1 GABA-C receptors as well (19). Finally, enflurane may enhance the effect of serotonin at 5-HT3 receptor channels (20). Indications: |
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Possible Mechanisms of Action: Halothane activates human tandem pore domain potassium channels such as TRESK (3), TREK-1 (31), TREK-2 (32), TASK-1 (31, 33), and TASK-3 (33). In addition, halothane may inhibit voltage-gated Na+ channels (12). The drug may also inhibit L-type voltage-gated calcium channels (34). Furthermore, halothane might weakly inhibit T-type voltage-gated calcium channels (35). Halothane also inhibits plasma membrane Ca2+-ATPase and sarcoplasmic reticulum Ca2+-ATPase (16). In skeletal muscle, the drug induces the release of Ca2+ from the sarcoplasmic reticulum Ca2+ release channel, also known as the ryanodine receptor (36). At sub-anesthetic doses, halothane inhibits the exchange of GTPγS for GDP bound to the nucleotide binding site of a subset of Gα (G alpha) proteins; these include Gαi2 > Gαi1 > Gαi3 > Gαs (15). Indications: |
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Possible Mechanisms of Action: Isoflurane may inhibit voltage-gated Na+ channels (12). The drug may also inhibit L-type voltage-gated calcium channels (34). Isoflurane might also weakly inhibit T-type voltage-gated calcium channels (22, 38). Isoflurane is likely to activate human tandem pore domain potassium channels such as TRESK (3), TREK-1 (31), TREK-2 (32), TASK-1 (31), and TASK-3 (39). Isoflurane also inhibits plasma membrane Ca2+-ATPase and sarcoplasmic reticulum Ca2+-ATPase (16). The drug may also increase the release of Ca2+ from sarcoplasmic reticulum Ca2+ release channels in muscle cells (17). At sub-anesthetic doses, isoflurane inhibits the exchange of GTPγS for GDP bound to the nucleotide binding site of a subset of Gα (G alpha) proteins; these include Gαi2 > Gαi1 > Gαi3 > Gαs (15). Indications: |
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Possible Mechanisms of Action: Indications: Ketamine hydrochloride injection is indicated for the induction of anesthesia prior to the administration of other general anesthetic agents. Ketamine hydrochloride injection is indicated to supplement low-potency agents, such as nitrous oxide. Specific areas of application are described in the CLINICAL PHARMACOLOGY section of the prescribing information. |
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Brevital Sodium can be used in pediatric patients older than 1 month as follows:
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Possible Mechanisms of Action: Nitrous oxide increases the production of nitric oxide (NO) via the neuronal isoform of nitric oxide synthase (nNOS) (50). Nitrous oxide- induced NO production may lead to the neuronal release of endogenous opioid peptides (50). Indications: |
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Possible Mechanisms of Action: In addition, propofol may have a small but significant inhibitory effect on voltage-dependent Na+ channels (12). Propofol may also inhibit T-type voltage-gated calcium channels (22, 23). Finally, propofol is an inhibitor of fatty acid amide hydrolase (53). Indications: |
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Possible Mechanisms of Action: Sevoflurane may inhibit voltage-gated Na+ channels (55). The drug may also inhibit L-type voltage-gated calcium channels (56). Sevoflurane might inhibit T-type voltage-gated calcium channels as well (57). In skeletal muscle, sevoflurane induces the release of Ca2+ from the sarcoplasmic reticulum Ca2+ release channel, also known as the ryanodine receptor (36). Furthermore, sevoflurane is a potent activator of the human tandem pore domain potassium channel, TRESK (3). The drug is also likely to activate the human tandem pore domain potassium channel TASK-1 (58). At sub-anesthetic doses, sevoflurane inhibits the exchange of GTPγS for GDP bound to the nucleotide binding site of a subset of Gα (G alpha) proteins; these include Gαi2 > Gαi1 > Gαi3 > Gαs (15). Indications: |
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Volatile anesthetics modulate the binding of guanine nucleotides to the alpha subunits of heterotrimeric GTP binding proteins.
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16. Lopez MM, Kosk-Kosicka D
How do volatile anesthetics inhibit Ca(2+)-ATPases?
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The effects of volatile anesthetics on calcium regulation by malignant hyperthermia-susceptible sarcoplasmic reticulum.
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Inhibition of rho1 receptor GABAergic currents by alcohols and volatile anesthetics.
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Amino acids in transmembrane domain two influence anesthetic enhancement of serotonin-3A receptor function.
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21. Yang J, Uchida I
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Neuroscience. 1996 Jul;73(1):69-78. [Abstract]
22. Todorovic SM, Perez-Reyes E, Lingle CJ
Anticonvulsants but not general anesthetics have differential blocking effects on different T-type current variants.
Mol Pharmacol. 2000 Jul;58(1):98-108. [Full Text]
23. Joksovic PM, Brimelow BC, Murbartián J, Perez-Reyes E, Todorovic SM
Contrasting anesthetic sensitivities of T-type Ca2+ channels of reticular thalamic neurons and recombinant Ca(v)3.3 channels.
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Effect of a single bolus of etomidate upon eight major corticosteroid hormones and plasma ACTH.
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27. Daniels S, Roberts RJ
Post-synaptic inhibitory mechanisms of anaesthesia; glycine receptors.
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Isoflurane modulation of neuronal nicotinic acetylcholine receptors expressed in human embryonic kidney cells.
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31. Patel AJ, Honoré E, Lesage F, Fink M, Romey G, Lazdunski M
Inhalational anesthetics activate two-pore-domain background K+ channels.
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32. Lesage F, Terrenoire C, Romey G, Lazdunski M
Human TREK2, a 2P domain mechano-sensitive K+ channel with multiple regulations by polyunsaturated fatty acids, lysophospholipids, and Gs, Gi, and Gq protein-coupled receptors.
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33. Talley EM, Bayliss DA
Modulation of TASK-1 (Kcnk3) and TASK-3 (Kcnk9) potassium channels: volatile anesthetics and neurotransmitters share a molecular site of action.
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34. Kamatchi GL, Durieux ME, Lynch C
Differential sensitivity of expressed L-type calcium channels and muscarinic M(1) receptors to volatile anesthetics in Xenopus oocytes.
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38. McDowell TS, Pancrazio JJ, Barrett PQ, Lynch C
Volatile anesthetic sensitivity of T-type calcium currents in various cell types.
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47. Yamakura T, Harris RA
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48. Todorovic SM, Jevtovic-Todorovic V, Mennerick S, Perez-Reyes E, Zorumski CF
Ca(v)3.2 channel is a molecular substrate for inhibition of T-type calcium currents in rat sensory neurons by nitrous oxide.
Mol Pharmacol. 2001 Sep;60(3):603-10. [Full Text]
49. Gruss M, Bushell TJ, Bright DP, Lieb WR, Mathie A, Franks NP
Two-pore-domain K+ channels are a novel target for the anesthetic gases xenon, nitrous oxide, and cyclopropane.
Mol Pharmacol. 2004 Feb;65(2):443-52. [Full Text]
50. Li S, Bieber AJ, Quock RM
Antagonism of nitrous oxide antinociception in mice by antisense oligodeoxynucleotide directed against neuronal nitric oxide synthase enzyme.
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51. Pistis M, Belelli D, Peters JA, Lambert JJ
The interaction of general anaesthetics with recombinant GABAA and glycine receptors expressed in Xenopus laevis oocytes: a comparative study.
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52. Cacheaux LP, Topf N, Tibbs GR, Schaefer UR, Levi R, Harrison NL, Abbott GW, Goldstein PA
Impairment of hyperpolarization-activated, cyclic nucleotide-gated channel function by the intravenous general anesthetic propofol.
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53. Patel S, Wohlfeil ER, Rademacher DJ, Carrier EJ, Perry LJ, Kundu A, Falck JR, Nithipatikom K, Campbell WB, Hillard CJ
The general anesthetic propofol increases brain N-arachidonylethanolamine (anandamide) content and inhibits fatty acid amide hydrolase.
Br J Pharmacol. 2003 Jul;139(5):1005-13. [Full Text]
54. Matute E, Lopez-Garcia JA
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55. Burke D, Bartley K, Woodforth IJ, Yakoubi A, Stephen JP
The effects of a volatile anaesthetic on the excitability of human corticospinal axons.
Brain. 2000 May;123 ( Pt 5):992-1000. [Full Text]
56. Fassl J, Halaszovich CR, Hüneke R, Jüngling E, Rossaint R, Lückhoff A
Effects of inhalational anesthetics on L-type Ca2+ currents in human atrial cardiomyocytes during beta-adrenergic stimulation.
Anesthesiology. 2003 Jul;99(1):90-6. [Abstract]
57. Joksovic PM, Bayliss DA, Todorovic SM
Different kinetic properties of two T-type Ca2+ currents of rat reticular thalamic neurones and their modulation by enflurane.
J Physiol. 2005 Jul 1;566(Pt 1):125-42. [Full Text]
58. Sirois JE, Lei Q, Talley EM, Lynch C, Bayliss DA
The TASK-1 two-pore domain K+ channel is a molecular substrate for neuronal effects of inhalation anesthetics.
J Neurosci. 2000 Sep 1;20(17):6347-54. [Full Text]
59. Cordato DJ, Chebib M, Mather LE, Herkes GK, Johnston GA
Stereoselective interaction of thiopentone enantiomers with the GABA(A) receptor.
Br J Pharmacol. 1999 Sep;128(1):77-82. [Full Text]
60. Zhan RZ, Fujiwara N, Yamakura T, Taga K, Fukuda S, Shimoji K
Differential inhibitory effects of thiopental, thiamylal and phenobarbital on both voltage-gated calcium channels and NMDA receptors in rat hippocampal slices.
Br J Anaesth. 1998 Dec;81(6):932-9. [Full Text]
61. Downie DL, Franks NP, Lieb WR
Effects of thiopental and its optical isomers on nicotinic acetylcholine receptors.
Anesthesiology. 2000 Sep;93(3):774-83. [Abstract]