Methoxyflurane revisited: tale of an anesthetic from cradle to grave.

New insights into the mechanism of methoxyflurane nephrotoxicity and implications for anesthetic development (part 1): Identification of the nephrotoxic metabolic pathway.

BACKGROUND Methoxyflurane nephrotoxicity results from biotransformation; inorganic fluoride is a toxic metabolite. Concern exists about potential renal toxicity from volatile anesthetic defluorination, but many anesthetics increase fluoride concentrations without consequence. Methoxyflurane is metabolized by both dechlorination to methoxydifluoroacetic acid (MDFA, which may degrade to fluoride)...

Cradle to Grave : The Environmental Impacts from Coal Cradle to Grave : The Environmental Impacts from Coal Clean Air Task

Effect of enzyme induction on nephrotoxicity of halothane-related compounds.

Nephrotoxicity following administration of methoxyflurane has been shown to be directly related to anesthetic metabolism to inorganic fluoride. Enzyme induction should increase metabolic rate and the amount of inorganic fluoride that is released. In vivo studies in Fischer 344 rats show that enzyme induction with phenobarbital or phenytoin increases defluorination following methoxyflurane anest...

St1b Waste Anesthetic Gases: the Invisible Threat

Waste anesthetic gases (WAGs) can be defined as all halogenated organic compounds (including methoxyflurane, halothane, isoflurane, sevoflurane, desflurane, and enflurane) and nitrous oxide that escape from the anesthetic circuit, or are exhaled by the patient. Management of WAGs intuitively seems prudent, but because excessive exposure is often difficult to detect without special monitoring de...

Exploring the Feasibility of Cradle to Cradle (Product) Design: Perspectives from New Zealand Scientists

This research project explores the feasibility of a Cradle to Cradle approach to sustainable product design in New Zealand. A framework for sustainable design was proposed by environmental chemist Michael Braungart and architect William McDonough who suggest that the current paradigm of “cradle to grave” product development is unable to provide a solution to the world’s current ecological crisi...