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methoxyflurane

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Methoxyflurane is a volatile liquid (bp=105°C) with a highblood:gas partition coefficient and thus a slow induction andprolonged recovery. Approximately 75% of the drug undergoesmetabolism yielding dichloroacetate, difluoromethoxyacetate,oxalate, and fluoride ions. The intrarenal inorganicfluoride concentration, as a result of renal defluorination, maybe responsible for the nephrotoxicity seen with methoxyflurane.Both the concentration of F<sup>-</sup> generated and the durationfor which it remained elevated were factors in the developmentof methoxyflurane nephrotoxicity. Methoxyfluranewas removed from the U.S. market in 2000 because of saferalternatives. Both isoflurane and enflurane produce less fluorideion upon metabolism than methoxyflurane.

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