Which of the following inhalational anaesthetic agent can cause hepatitis on repeated use?
**Core Concept**
The question is testing the knowledge of a specific inhalational anaesthetic agent associated with hepatitis on repeated use. This is a classic example of an adverse effect related to chronic exposure.
**Why the Correct Answer is Right**
The correct answer is **Halothane**. Halothane hepatitis is a rare but serious adverse effect that can occur with repeated exposure to this agent. The pathophysiology involves an immune-mediated reaction triggered by the metabolism of halothane by the liver enzyme cytochrome P450. This results in the formation of reactive metabolites that can bind to cellular proteins and trigger an immune response, leading to liver damage. The risk of halothane hepatitis is increased in individuals with pre-existing liver disease.
**Why Each Wrong Option is Incorrect**
* **Option A:** Isoflurane is not commonly associated with hepatitis on repeated use. It is a commonly used inhalational anaesthetic agent with a favorable safety profile.
* **Option B:** Sevoflurane can cause nephrotoxicity due to the formation of compound A, but it is not typically associated with hepatitis.
* **Option D:** Desflurane is a newer inhalational anaesthetic agent with a low risk of adverse effects, including hepatitis.
**Clinical Pearl / High-Yield Fact**
Halothane hepatitis is a rare but serious adverse effect that can occur with repeated exposure to this agent. It is essential to use alternative agents when possible and to monitor liver function tests in patients undergoing multiple exposures to halothane.
**Correct Answer:** C. Halothane