Entonox EP
Entonox EP Uses, Dosage, Side Effects, Food Interaction and all others data.
The pharmacological mechanism of action of N2O in medicine is not fully known. However, it has been shown to directly modulate a broad range of ligand-gated ion channels, and this likely plays a major role in many of its effects. It moderately blocks NMDA and β2-subunit-containing nACh channels, weakly inhibits AMPA, kainate, GABAC, and 5-HT3 receptors, and slightly potentiates GABAA and glycine receptors. It also has been shown to activate two-pore-domain K+ channels. While N2O affects quite a few ion channels, its anaesthetic, hallucinogenic, and euphoriant effects are likely caused predominantly, or fully, via inhibition of NMDA receptor-mediated currents. In addition to its effects on ion channels, N2O may act to imitate nitric oxide in the central nervous system, and this may be related to its analgesic and anxiolytic properties.
Oxygen is used as a medical treatment in both chronic and acute cases, and can be used in hospital, pre-hospital or entirely out of hospital, dependent on the needs of the patient and their medical professionals' opinions.
| Trade Name | Entonox EP |
| Generic | Nitrous Oxide + Oxygen |
| Weight | 50% + 50% |
| Type | Gas |
| Therapeutic Class | General (Inhalation) anesthetics |
| Manufacturer | Linde Bangladesh Limited |
| Available Country | Bangladesh |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Acute trauma, Colonoscopy, Fracture and joint manipulation, Labour induction, Obstetric analgesia, Pain, Sedation, Short-term pain relief, Tooth extraction, Wound and burn dressing, Wound debribement and suturing
Entonox EP is also used to associated treatment for these conditions: Analgesia, General AnesthesiaAnemia, Hypoxemia, Hypoxia, Malignancies, Migraine, Polycythemia, Pulmonary Hypertension (PH), Respiratory Disorders, Sleep Apnea
How Entonox EP works
Findings to date indicate that nitrous oxide induces opioid peptide release in the brain stem leading to the activation of descending noradrenergic neurones, which results in modulation of the nociceptive process in the spinal cord. Several receptor–effector mechanisms including dopamine receptors, α2 adrenoceptors, benzodiazepine receptors and -methyl- -aspartate (NMDA) receptors have been implicated although the relationship of one with the other is not known.
Oxygen therapy increases the arterial pressure of oxygen and is effective in improving gas exchange and oxygen delivery to tissues, provided that there are functional alveolar units. Oxygen plays a critical role as an electron acceptor during oxidative phosphorylation in the electron transport chain through activation of cytochrome c oxidase (terminal enzyme of the electron transport chain). This process achieves successful aerobic respiration in organisms to generate ATP molecules as an energy source in many tissues. Oxygen supplementation acts to restore normal cellular activity at the mitochondrial level and reduce metabolic acidosis. There is also evidence that oxygen may interact with O2-sensitive voltage-gated potassium channels in glomus cells and cause hyperpolarization of mitochondrial membrane .
Dosage
Entonox EP dosage
Adult: This is used for more than a total of 24 hours, or more frequently than every 4 days, it must be used with close clinical supervision with hematological monitoring.
Child: Safety & Efficacy has not been established.
Side Effects
Minimal side-effects are found
Toxicity
May cause burns or frostbites in case of eye or skin contact with rapidly expanding gas. Oxygen therapy can induce hypercapnic respiratory failure in patients with respiratory diseases and musculoskeletal diseases in upper airways. Sudden cessation of oxygen supplementation in these patients can further lead to rebound hypoxaemia. In patients with mild or moderate strokes, hyperoxaemia may cause absorption atelectasis or myocardial infarction. Oxygen content should be monitored following the administration to verify therapeutic benefit.
Precaution
It may cause vitamin B12 deficiency in susceptible patients (usually related to prolonged use of the gas or where an existing deficiency is present). Prolonged inhalation can also result in dryness of the mouth and discomfort.
Interaction
There are no known drug interactions and none well documented.
Half Life
Approximately 122.24 seconds
Elimination Route
Exhalation
Pregnancy & Breastfeeding use
Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.
Contraindication
Pneumothorax, abdominal distension, suspected intestinal obstruction, bullous emphysema, middle ear procedures, following a recent dive. It should also be avoided where the patient is unable to effectively make use of the gas delivery equipment such as maxillo-facial injuries, impaired consciousness, sedation or intoxication.
Storage Condition
Oxygen should be kept as compressed gas or liquid at cryogenic temperature, in appropriate containers complying withthe safety regulations of the national authority. Valves or taps should not be lubricated with oil or grease.
Innovators Monograph
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