What Medications Can Cause Malignant Hyperthermia?
Volatile Inhalation Anesthetics
This is the most common mathematical group of medications that gives rise to malignant hyperthermia ( MH ) . Volatile inhalation medications include :
Halothane : Malignant hyperthermy is triggered quicker with halothane compare to the other volatile inhalation medications . Median is 20 minutes and it can swan between 5 to 45 moment .
Isoflurane : The average time malignant hyperthermia was triggered was 30 minutes and it can crop from 5 to 210 min . So , after halothane isoflurane is the medication that has a less median time to touch off malignant hyperthermy .
Sevoflurane : The median meter malignant hyperthermy was trigger was 60 minutes and it can range from 10 to 210 minutes .
Ethrane : The medial time malignant hyperthermy was touch off was 55 minutes and it can range from 20 to 480 moment .
Methoxyflurane : study have prove methoxyflurane also triggers malignant hyperthermia
Desflurane : Studies have shown desflurane medication also trigger off malignant hyperthermia
From the above selective information you see that isoflurane , enflurane and sevoflurane medications have a delayed anesthesia trigger of malignant hyperthermy compared to halothane . But do keep in mind any of these drug can trigger malignant hyperthermia very quickly within minutes after induction of anesthesia .
Ether And Ether Derivatives : It is a flammable and explosive agentive role and ask particular precaution when it is used as an anesthetic agent therefore , not commonly used now .
An clause write in British Journal of Anesthesia shows in UK ; in the preceding 40 year ’s halothane triggered malignant hyperthermia in most cases , but with serious hepatotoxicity it causes , it is not normally used in UK now . Isoflurane and sevoflurane were the rough-cut explosive anaesthetic medications used over the past 3 years ; therefore many pillowcase of reported malignant hyperthermy are triggered by these two agent . The study also suggests that malignant hyperthermy trigger by drugs can be drug dependent , but the minimum VD that can trigger off malignant hyperthermia in each medication is unknown .
Succinylcholine
Succinylcholine medicine is depolarise muscle relaxant that is given intravenously . This is used with general anesthesia as an auxiliary to help tracheal intubation and to slacken the muscles during surgical process . One subject has show that when a potent volatile anaesthetic agent is combined with succinylcholine the serum creatinine kinase ( it ’s a ware free from damaged haggard muscular tissue ) degree were six to ten times gamey than when only an anesthetic agent is the initiation of malignant hyperthermy . Another evince when halothane and succinylcholine combination enhance the malignant hyperthermia trigger . Some studies show that succinylcholine medication alone also trigger malignant hyperthermia and some show succinylcholine alone does not touch off malignant hyperthermia . Therefore , the subject remains controversial but most believed that inhalation anesthetic agent and succinylcholine together can rapidly trigger malignant hyperthermia . So , the combination should be always avoided .
Anticholinergic Medications
Some studies say the combining of anticholinergic medications with volatile inhalation anaesthetic medicament cause malignant hyperthermy . The topic remain controversial .
Drugs That Are Safe To Use In Malignant Hyperthermia
Summary
fickle inhalation anesthetic medications such as halothane , isoflurane , sevoflurane , enflurane , methoxyflurane , desflurane , and ether trigger malignant hyperthermia . Out of this halothane trigger malignant hyperthermy quickly compared to the other anaesthetic agents ( average 20 minutes ) . But malignant hyperthermia can be triggered within minute to few hours after the induction of inhalant general anesthesia with these agent . Succinylcholine also trigger malignant hyperthermia when combined with volatile inspiration anesthetic medications , the development of malignant hyperthermia is enhanced with the combining . Although this matter remains controversial some sketch also show that anticholinergic drug when combine with volatile inhalation anesthetic drug touch off malignant hyperthermy .
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