Forane100 ml

Forane 100 ml may be used for induction and maintenance of general anesthesia. Adequate data have not been developed to establish its application in obstetrical anesthesia.

General (Inhalation) anesthetics

Forane 100 ml may be used for induction and maintenance of general anesthesia. Adequate data have not been developed to establish its application in obstetrical anesthesia.Induction of and recovery from Forane 100 ml anesthesia are rapid. Forane 100 ml has a mild pungency, which limits the rate of induction, although excessive salivation or tracheobronchial secretions do not appear to be stimulated. Pharyngeal and laryngeal reflexes are readily obtunded. The level of anesthesia may be changed rapidly with Forane 100 ml. Forane 100 ml is a profound respiratory depressant. Respiration must be monitored closely and supported when necessary. As anesthetic dose is increased, tidal volume decreases and respiratory rate is unchanged. This depression is partially reversed by surgical stimulation, even at deeper levels of anesthesia. Forane 100 ml evokes a sigh response reminiscent of that seen with diethyl ether and enflurane, although the frequency is less than with enflurane.Blood pressure decreases with induction of anesthesia but returns toward normal with surgical stimulation. Progressive increases in depth of anesthesia produce corresponding decreases in blood pressure. Nitrous oxide diminishes the inspiratory concentration of Forane 100 ml required to reach a desired level of anesthesia and may reduce the arterial hypotension seen with Forane 100 ml alone. Heart rhythm is remarkably stable. With controlled ventilation and normal PaCO2, cardiac output is maintained despite increasing depth of anesthesia, primarily through an increase in heart rate, which compensates for a reduction in stroke volume. The hypercapnia, which attends spontaneous ventilation during Forane 100 ml anesthesia further increases heart rate and raises cardiac output above awake levels. Forane 100 ml does not sensitize the myocardium to exogenously administered epinephrine in the dog. Limited data indicate that subcutaneous injection of 0.25 mg of epinephrine (50 mL of 1:200,000 solution) does not produce an increase in ventricular arrhythmias in patients anesthetized with Forane 100 ml.Muscle relaxation is often adequate for intra-abdominal operations at normal levels of anesthesia. Complete muscle paralysis can be attained with small doses of muscle relaxants. All commonly used muscle relaxants are markedly potentiated with Forane 100 ml, the effect being most profound with the nondepolarizing type. Neostigmine reverses the effect of nondepolarizing muscle relaxants in the presence of Forane 100 ml. All commonly used muscle relaxants are compatible with Forane 100 ml.Forane 100 ml can produce coronary vasodilation at the arteriolar level in selected animal models; the drug is probably also a coronary dilator in humans. Forane 100 ml, like some other coronary arteriolar dilators, has been shown to divert blood from collateral dependent myocardium to normally perfused areas in an animal model (“coronary steal”). Clinical studies to date evaluating myocardial ischemia, infarction and death as outcome parameters have not established that the coronary arteriolar dilation property of Forane 100 ml is associated with coronary steal or myocardial ischemia in patients with coronary artery disease

Premedication: Premedication should be selected according to the need of the individual patient, taking into account that secretions are weakly stimulated by Forane 100 ml, and the heart rate tends to be increased. The use of anticholinergic drugs is a matter of choice.Inspired Concentration: The concentration of Forane 100 ml being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using:Vaporizers calibrated specifically for Forane 100 ml;Vaporizers from which delivered flows can be calculated, such as vaporizers delivering a saturated vapor, which is then diluted. The delivered concentration from such a vaporizer may be calculated using the formula: % Forane 100 ml = 100 PvFv/FT (PA - PV)Where: PA= Pressure of atmosphere PV= Vapor pressure of Forane 100 ml FV= Flow of gas through vaporizer (mL/min) FT= Total gas flow (mL/min) Forane 100 ml contains no stabilizer. Nothing in the agent alters calibration or operation of these vaporizers.Induction: Induction with Forane 100 ml in oxygen or in combination with oxygen-nitrous oxide mixtures may produce coughing, breath holding, or laryngospasm. These difficulties may be avoided by the use of a hypnotic dose of an ultra-short-acting barbiturate. Inspired concentrations of 1.5 to 3.0% Forane 100 ml usually produce surgical anesthesia in 7 to 10 minutes.Maintenance: Surgical levels of anesthesia may be sustained with a 1.0 to 2.5% concentration when nitrous oxide is used concomitantly. An additional 0.5 to 1.0% may be required when Forane 100 ml is given using oxygen alone. If added relaxation is required, supplemental doses of muscle relaxants may be used.The level of blood pressure during maintenance is an inverse function of Forane 100 ml concentration in the absence of other complicating problems. Excessive decreases may be due to depth of anesthesia and in such instances may be corrected by lightening anesthesia.

Premedication: Premedication should be selected according to the need of the individual patient, taking into account that secretions are weakly stimulated by Forane 100 ml, and the heart rate tends to be increased. The use of anticholinergic drugs is a matter of choice.Inspired Concentration: The concentration of Forane 100 ml being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using:Vaporizers calibrated specifically for Forane 100 ml;Vaporizers from which delivered flows can be calculated, such as vaporizers delivering a saturated vapor, which is then diluted. The delivered concentration from such a vaporizer may be calculated using the formula: % Forane 100 ml = 100 PvFv/FT (PA - PV)Where: PA= Pressure of atmosphere PV= Vapor pressure of Forane 100 ml FV= Flow of gas through vaporizer (mL/min) FT= Total gas flow (mL/min) Forane 100 ml contains no stabilizer. Nothing in the agent alters calibration or operation of these vaporizers.Induction: Induction with Forane 100 ml in oxygen or in combination with oxygen-nitrous oxide mixtures may produce coughing, breath holding, or laryngospasm. These difficulties may be avoided by the use of a hypnotic dose of an ultra-short-acting barbiturate. Inspired concentrations of 1.5 to 3.0% Forane 100 ml usually produce surgical anesthesia in 7 to 10 minutes.Maintenance: Surgical levels of anesthesia may be sustained with a 1.0 to 2.5% concentration when nitrous oxide is used concomitantly. An additional 0.5 to 1.0% may be required when Forane 100 ml is given using oxygen alone. If added relaxation is required, supplemental doses of muscle relaxants may be used.The level of blood pressure during maintenance is an inverse function of Forane 100 ml concentration in the absence of other complicating problems. Excessive decreases may be due to depth of anesthesia and in such instances may be corrected by lightening anesthesia.

Enhances effects of neuromuscular blockers. May sensitise the myocardium to adrenaline and other sympathomimetics. Enhances hypotensive effects of ACE inhibitors, TCAs, MAOIs, antihypertensives, antipsychotics or beta-blockers. May have synergistic effects with CNS depressants.

Known or suspected susceptibility to malignant hyperthermia. Porphyria.

Nausea, Vomiting, Shivering, Dose-dependent hypotension, Arrhythmias, Malignant hyperthermia (rare), Elevations in white blood count, May decrease creatinine and increase BUN, Ileus, severe (fatal), Hepatic dysfunction (postoperative period),Respiratory depression may occur

Pregnancy Category C. Forane 100 ml has been shown to have a possible anesthetic-related fetotoxic effect in mice when given in doses 6 times the human dose. There are no adequate and well-controlled studies in pregnant women. Forane 100 ml should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Forane 100 ml is administered to a nursing woman.

Perioperative hyperkalaemia; raised intracranial pressure. May impair ability to drive or operate machinery. Pregnancy and lactation. Do not allow carbon dioxide absorbents in anaesthetic apparatus to dry out when delivering Forane 100 ml to minimise the risk of developing elevated carboxyhaemoglobin levels.

Store at room temperature 15°-30°C. Forane 100 ml contains no additives and has been demonstrated to be stable at room temperature for periods in excess of five years.

General (Inhalation) anesthetics

Forane 100 ml may be used for induction and maintenance of general anesthesia. Adequate data have not been developed to establish its application in obstetrical anesthesia.Induction of and recovery from Forane 100 ml anesthesia are rapid. Forane 100 ml has a mild pungency, which limits the rate of induction, although excessive salivation or tracheobronchial secretions do not appear to be stimulated. Pharyngeal and laryngeal reflexes are readily obtunded. The level of anesthesia may be changed rapidly with Forane 100 ml. Forane 100 ml is a profound respiratory depressant. Respiration must be monitored closely and supported when necessary. As anesthetic dose is increased, tidal volume decreases and respiratory rate is unchanged. This depression is partially reversed by surgical stimulation, even at deeper levels of anesthesia. Forane 100 ml evokes a sigh response reminiscent of that seen with diethyl ether and enflurane, although the frequency is less than with enflurane.Blood pressure decreases with induction of anesthesia but returns toward normal with surgical stimulation. Progressive increases in depth of anesthesia produce corresponding decreases in blood pressure. Nitrous oxide diminishes the inspiratory concentration of Forane 100 ml required to reach a desired level of anesthesia and may reduce the arterial hypotension seen with Forane 100 ml alone. Heart rhythm is remarkably stable. With controlled ventilation and normal PaCO2, cardiac output is maintained despite increasing depth of anesthesia, primarily through an increase in heart rate, which compensates for a reduction in stroke volume. The hypercapnia, which attends spontaneous ventilation during Forane 100 ml anesthesia further increases heart rate and raises cardiac output above awake levels. Forane 100 ml does not sensitize the myocardium to exogenously administered epinephrine in the dog. Limited data indicate that subcutaneous injection of 0.25 mg of epinephrine (50 mL of 1:200,000 solution) does not produce an increase in ventricular arrhythmias in patients anesthetized with Forane 100 ml.Muscle relaxation is often adequate for intra-abdominal operations at normal levels of anesthesia. Complete muscle paralysis can be attained with small doses of muscle relaxants. All commonly used muscle relaxants are markedly potentiated with Forane 100 ml, the effect being most profound with the nondepolarizing type. Neostigmine reverses the effect of nondepolarizing muscle relaxants in the presence of Forane 100 ml. All commonly used muscle relaxants are compatible with Forane 100 ml.Forane 100 ml can produce coronary vasodilation at the arteriolar level in selected animal models; the drug is probably also a coronary dilator in humans. Forane 100 ml, like some other coronary arteriolar dilators, has been shown to divert blood from collateral dependent myocardium to normally perfused areas in an animal model (“coronary steal”). Clinical studies to date evaluating myocardial ischemia, infarction and death as outcome parameters have not established that the coronary arteriolar dilation property of Forane 100 ml is associated with coronary steal or myocardial ischemia in patients with coronary artery disease

Pregnancy Category C. Forane 100 ml has been shown to have a possible anesthetic-related fetotoxic effect in mice when given in doses 6 times the human dose. There are no adequate and well-controlled studies in pregnant women. Forane 100 ml should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Forane 100 ml is administered to a nursing woman.