Drug General Information (ID: DDIX9ROZ6W)
Drug Name			Propofol		Drug Info		Methoxyflurane		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anxiolytics/Sedatives/Hypnotics				Anesthetics
Structure

Mechanism of Propofol-Methoxyflurane Interaction (Severity Level: Moderate)
Additive cardiorespiratory depression effects Click to Show/Hide Mechanism Graph
Drug Name		Propofol				Methoxyflurane
Mechanism 1		Cardiorespiratory depression effects				Cardiorespiratory depression effects
Key Mechanism Factor 1
		Factor Name		Cardiorespiratory depression effects
		Factor Description		Cardiorespiratory depression is a reduction or inhibition of the normal function of the heart and lungs. The heart and lungs are the most important organs of the body's circulatory system, and when excessively depressed may result in decreased heart rate, decreased blood pressure, heart failure, slowed breathing (little to no visible chest movement), apnea, narrowed or pinpoint pupils, and seizures.
Mechanism Description		Additive cardiorespiratory depression effects by the combination of Propofol and Methoxyflurane
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Propofol				Methoxyflurane
Mechanism 2		CNS depression effects				CNS depression effects
Key Mechanism Factor 2
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Propofol and Methoxyflurane

Recommended Action
Management		Patients should be monitored closely for excessive sedation and cardiorespiratory depression, and the medication dosage(s) adjusted accordingly. Supportive therapy should be provided if needed.

References
1	Gill SS, Wright EM, Reilly CS "Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study." Br J Anaesth 65 (1990): 760-5. [PMID: 2265045]
2	Hamaoka N, Oda Y, Hase I, Mizutani K, Nakamoto T, Ishizaki T, Asada A "Propofol decreases the clearance of midazolam by inhibiting CYP3A4: An in vivo and in vitro study." Clin Pharmacol Ther 66 (1999): 110-7. [PMID: 10460064]
3	McClune S, McKay AC, Wright PM, et al "Synergistic interaction between midazolam and propofol." Br J Anaesth 69 (1992): 240-5. [PMID: 1389840]
4	Pavlin DJ, Coda B, Shen DD, et al "Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers." Anesthesiology 84 (1996): 23-37. [PMID: 8572340]
5	Product Information. Diprivan (propofol). Zeneca Pharmaceuticals, Wilmington, DE.
6	Product Information. Lusedra (fospropofol). Eisai Inc, Teaneck, NJ.