Porphyrinogenicity of etomidate and ketamine as continuous infusions. Screening in the DDC-primed rat model.
The porphyrinogenicity of etomidate and ketamine administered as continuous i.v. infusions was screened in the DDC-primed rat model of latent variegate porphyria. Ketamine produced no change from control in 5-aminolaevulinate synthase (ALAs) activity and haem intermediate production in either untreated or DDC-primed rats, and would appear to be safe for use in the patient with genetic porphyria. Etomidate, while producing no significant changes in these parameters in untreated rats, caused a statistically significant 47% increase in hepatic ALAs activity with a corroborative 85% increase in coproporphyrin and a 40% increase in protoporphyrin content, in DDC-primed rats. On these grounds, etomidate must be regarded as potentially porphyrinogenic when administered as a continuous infusion for total i.v. anaesthesia.
D000624:5-Aminolevulinate Synthetase / Q000378:metabolism; D000771:Anesthesia, Intravenous; D000818:Animals; D003997:Dicarbethoxydihydrocollidine; D004195:Disease Models, Animal; D005045:Etomidate / Q000009:adverse effects*; D007093:Imidazoles / Q000009:adverse effects*; D007649:Ketamine / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects; D008297:Male; D011164:Porphyrias / Q000139:chemically induced*; D011166:Porphyrins / Q000032:analysis; D051381:Rats; D011919:Rats, Inbred Strains; D013997:Time Factors
D007093:Imidazoles; D011166:Porphyrins; D003997:Dicarbethoxydihydrocollidine; D007649:Ketamine; D000624:5-Aminolevulinate Synthetase; D005045:Etomidate