N01AB07 - Desflurane |
Propably not porphyrinogenic |
PNP |
Rationale
Desfluran is barely metabolised in the body and it has been reported used safely in a patient. One reference consider it probably safe.
Chemical description
(±)-2-Difluoromethyl 1,2,2,2-tetrafluoroethyl ether. M= 168.0. Fluorinated ethylmethyl ether, boiling point of 22,8 degrees celcius.
Therapeutic characteristics
Inhalation anestethic, used in induction and maintenance of general anesthesia also in children.
Hepatic exposure
As for all inhalation anesthetics the hepatic exposure will be sufficient enough to affect the porphyria status of the patient.
Metabolism and pharmakokinetics
Only 0,02% of the drug is metabolised probably by CYP 2E1, and there is only a marginal increase in inorganic fluoride concentrations in the urine after desflurane administration. It is excreted mainly unchanged through the lungs.
Preclinical data
None.
Published experience
There is one published case of desfluran used by an AIP patient. The patient had increased PBG levels preoperation, despite this the patient had no symptoms and PBG levels decreased back to normal after the operation (Messmer M, et al. 2004).
References
- Scientific articles
- Böhrer H, et al. Leitlinie zur durchführung von anästhesien bei patienten mit porphyrie. Anästhesiologie & intensivmedizin 2002;43:485-9. #2417
- Messmer M, et al. Desfluran bei akuter intermittierender porphyrie. Anaesthesist 2004;53:244-8. #2421
- Summary of Product Characteristics
- Statens Legemiddelverk. Summary of product characteristics (SPC) Suprane. www.legemiddelverket.no/spc (in Norwegian). Read 29.05.2008. #2422
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