Monograph
N01AX13 - Nitrous Oxide |
Propably not porphyrinogenic |
PNP |
Rationale
Nitrous oxide is rapidly eliminated unchanged via the lungs, and has no potential for CYP interactions. Common adverse reactions of nitrous oxide that can be confused with an acute porphyric attack are nausea and vomiting.
Chemical description
Nitrous oxide is a medicinal gas with the chemical formula N2O.
Therapeutic characteristics
Nitrous oxide has analgesic and sedative properties and is used in the management of mild to moderate pain and in general anaesthesia in combination with other anaesthetics. It has a rapid onset and offset of effect.
Nitrous oxide is administered by inhalation, and should be combined with oxygen to prevent hypoxia. Common adverse reactions of nitrous oxide that can be confused with an acute porphyric attack are nausea and vomiting.
Metabolism and pharmacokinetics
Nitrous oxide is excreted unchanged via the lungs. Because of its low solubility in blood, it is rapidly distributed to the tissue giving a rapid onset of effect. No pharmacokinetic interactions between nitrous oxide and other drugs are observed or suspected.
Published experience
Reports of uneventful use:
Barone 2001: used uneventfully by 1 patient with AIP.
Brown 2002: used uneventfully by 1 patient with VP.
Famewo 1985: used uneventfully by 1 patient with AIP.
McGovern 2007: used uneventfully by two children with latent AIP.
Minoda 1997: used uneventfully by 1 patient with VP:
Sarantopoulos 2000: used uneventfully by 1 patient with HCP.
Shipton 1984: used uneventfully by 1 patient with VP.
Yamamori 1996: used uneventfully by 1 patient with HCP
Similar drugs
References
| # | Citation details | PMID |
|---|---|---|
| * | Scientific articles | |
| 1. | CD. Uneventful propofol anesthesia in a patient with coexisting hereditary coproporphyria and hereditary angioneurotic edema.
Anesthesiology. 2000 Feb;92(2):607-9. |
|
| 2. | Shipton EA, Roelofse JAAnaesthesia in a patient with variegate porphyria undergoing coronary bypass surgery. A case report.
S Afr Med J. 1984 Jan 14;65(2):53-4. |
|
| 3. | The tolerability of newer immunosuppressive medications in a patient with acute intermittent porphyria.
Barone GW, Gurley BJ,et al. J Clin Pharmacol. 2001 Jan;41(1):113-5 |
|
| 4. | Nitrous oxide and the inhalation anesthetics.
Becker DE, Rosenberg M. Anesth Prog. 2008 Winter;55(4):124-30 |
|
| 5. | The management of porphyria in dental practice.
Brown GJ, Welbury RR. Br Dent J. 2002 Aug 10;193(3):145-6. |
12213008 |
| 6. | Induction of anaesthesia with etomidate in a patient with acute intermittent porphyria.
Famewo CE. Can Anaesth Soc J. 1985 Mar;32(2):171-3. |
|
| 7. | The dental management of five paediatric patients with a history of acute intermittent porphyria.
McGovern E, Fleming P, et al. Eur Arch Paediatr Dent. 2007 Dec;8(4):215-8. |
18076854 |
| 8. | Anesthetic management of a patient with variegate porphyria. J Anesth 1997;11:307-308.
Minoda Y, Oshimine KY, et al. |
28921072 |
| 9. | Uneventful propofol anesthesia in a patient with coexisting hereditary coproporphyria and hereditary angioneurotic edema.
Sarantopoulos CD, Bratanow NC, et al. Anesthesiology. 2000 Feb;92(2):607-9. |
|
| 10. | Safety of isoflurane and epidural anesthesia in a patient with hereditary coproporphyria. J Anesth 1996 10:80-82
Yamamori Y, Sumi M, et al. |
|
| * | Summary of Product Characteristics | |
| 11. | Norwegian medicines agency. Summary of Product Characteristics (SPC). Niontix.
|
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Tradenames
This list comprises raw data collected from different countries.
In some cases, a more comprehensive list of available drug packages is included.
Consequently, very similar terms may therefore appear multiple times.
Bold names are the searchable terms, while the gray names that follow are all mapped to the bolded term.
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Distikstofoxide · Lachgas · Niontix 
Dinitrox · Kalinox bouteille · Niontix · Protoxyde d'Azote · Protoxyde d'Azote Médicinal 
Oxido Nitroso · Oxido Nitroso gas · Óxido Nitroso gas · Óxido Nitroso gas Licuado · Oxido Nitroso Líquido · Óxido Nitroso Líquido · Óxido Nitroso Metálicos · Oxido Nitroso Solgroup · Protoxido Nitrogeno 
Niontix · Protoxid Azot 
Nitrous Oxide 
Dinitrogenoxid · Niontix 
lystgass · Niontix 
Podtlenek azotu · Podtlenek azotu N2O 
Kalinox · Niontix · Protoxyde d'azote · Protoxyde d'azote Médicinal 
Lyfjatvíköfnunarefnisoxíð · Niontix 
Ilokaasu · Niontix 
Niontix · Slapekla oksiduls 
Azot suboksid · diazotoksid
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