Pentrox

Pentrox is a substance used to perform general anesthesia.

The component methoxyflurane increases the pain threshold in volunteers, and in addition, it is an effective analgesic in most people who require analgesia in emergency situations (for example, dislocations with fractures, dental surgery, changing the dressing in the burn area and for postoperative pain relief). [ 1 ]

Inhalation of small volumes of methoxyflurane vapors produces pain relief. [ 2 ]

Indications Pentrox

Used for trauma-related pain in conscious individuals with stable hemodynamic parameters. Also prescribed to relieve pain during short surgeries (e.g. changing or applying a surgical dressing).

Release form

The therapeutic element is released in the form of an inhalation liquid - inside a 3 ml container, 10 containers equipped with an inhaler, inside a box.

Pharmacodynamics

The introduction of methoxyflurane may cause drowsiness, but heart rhythm disturbances are usually not observed. Methoxyflurane has a rather weak effect on myocardial function. When using small anesthetic doses, there may be some decrease in blood pressure values, against which bradycardia develops. [ 3 ]

In addition, when blood pressure levels decrease, heart rate may decrease and cardiac output may weaken.

Pharmacokinetics

Methoxyflurane is transformed inside the body. 50-70% of the drug dosage is absorbed, and then metabolic processes develop with the formation of free oxalic and fluoric acids, as well as dichloroacetic and dichloromethoxyacetic acids. Free oxalic and fluoric acids can provoke renal dysfunction.

Methoxyflurane is more sensitive to metabolic processes than other methyl ethyl ethers of the halogen type and has a higher tendency to diffuse into fatty tissues. The active element of the drug is released from such a reservoir at a low rate, after which it undergoes transformations over several days.

About 20% of the absorbed substance is excreted with exhaled air; oxalic acid and organic fluorine are excreted in urine (about 30% of the absorbed portion).

Testing has shown that it takes less time for obese people to obtain blood fluoride Cmax values than normal weight and older people.

Dosing and administration

6 ml of the substance should be used per day (administered via an inhaler). To obtain an analgesic effect, it is necessary to use the minimum effective dosage.

Intermittent steam inhalation procedure is performed with a concentration in the range of 0.2-0.7%.

A maximum of 15 ml of the drug is allowed per week. The therapy should not be continued for a longer period.

• Application for children

There is no information regarding the use of the drug in pediatrics, which is why Pentrox is not prescribed to children.

Use Pentrox during pregnancy

Methoxyflurane should not be used during pregnancy because it may impair kidney function in the woman and cause nervous system dysfunction and respiratory depression in the infant.

During the period of therapy, it is necessary to stop breastfeeding.

Contraindications

Main contraindications:

• severe intolerance to fluorinated anesthetics;
• instability of the cardiovascular system function;
• use for local anesthesia;
• head injury;
• weakened renal function or renal insufficiency;
• depression of the respiratory process;
• loss of consciousness;
• presence in the anamnesis of adverse reactions associated with the use of drugs.

Side effects Pentrox

Common side effects include vomiting, drowsiness, retrograde amnesia and odor intolerance, as well as headaches, nausea, cough, polyuria, fever and dizziness.

Occasionally, hyperthermia or non-specific hepatitis develops.

Bronchial spasms, bradycardia, heart attack, laryngospasm, respiratory depression and decreased blood pressure are observed sporadically. In addition, renal failure, increased serum creatinine or urea levels, increased urinary oxalate secretion and increased serum inorganic fluoride levels develop. Muscle relaxation and pallor are also possible.

Overdose

The development of signs of poisoning can occur when using dosages prescribed for anesthesia.

After the end of the methoxyflurane procedure, the patient should be examined for symptoms such as pallor, drowsiness, and muscle relaxation. If increased urination is observed due to overdose, the loss of fluid and electrolytes should be immediately replenished.

Interactions with other drugs

There is information that the administration of the anesthetic methoxyflurane together with tetracycline causes fatal nephrotoxicity.

There is a possibility that Pentrox may potentiate the negative effect on the kidneys when used with other medications, including antibiotics with established nephrotoxic effects (this includes kanamycin and cephaloridine with gentamicin, as well as colistin, amphotericin B and polymyxin B). With further use, the dose of substances with a narcotic effect should be reduced.

Storage conditions

Pentrox should be stored in a place protected from small children, sunlight and moisture. Temperature indicators should not exceed 30°C.

Shelf life

Pentrox is approved for use within a 2-year period from the date of sale of the pharmaceutical product.

Analogues

Analogues of the drug are the medications Sevorane and Halothane with Foran, as well as Isoflurane and Sevoflurane.