A patient after giving inhalational anaestheia developed fulminant hepatitis, patient was exposed to same drug previously. Which is the drug?
**Core Concept**
Hepatitis due to inhalational anesthetics is a rare but serious complication, often associated with halogenated anesthetics, which can cause liver damage through a mechanism of mitochondrial dysfunction and oxidative stress.
**Why the Correct Answer is Right**
The correct answer is likely halothane, a halogenated anesthetic that has been linked to severe hepatitis in some patients. This is thought to occur due to the formation of trifluoroacetic acid, which can bind to and inactivate cytochrome P450 2E1, leading to the accumulation of toxic metabolites and subsequent liver damage. Patients who have been exposed to halothane previously may be at increased risk for this reaction due to the presence of pre-existing antibodies against the drug.
**Why Each Wrong Option is Incorrect**
* **Option A:** Isoflurane is another halogenated anesthetic, but it is generally considered to be less hepatotoxic than halothane. While it can still cause liver damage in rare cases, it is not as strongly associated with this complication.
* **Option B:** Sevoflurane is another commonly used inhalational anesthetic, but it has a lower risk of causing hepatitis compared to halothane. However, it can still cause liver damage in rare cases, especially in patients with pre-existing liver disease.
* **Option C:** Desflurane is a newer halogenated anesthetic that is considered to have a lower risk of causing hepatitis compared to halothane and other older agents. However, it is still possible for patients to experience liver damage with this drug, especially if they have pre-existing liver disease or are exposed to high concentrations.
**Clinical Pearl / High-Yield Fact**
When administering inhalational anesthetics, it's essential to consider the patient's previous exposure to these agents, as well as any pre-existing liver disease, to minimize the risk of hepatitis.
**Correct Answer: C. Desflurane.