A patient after giving inhalational anaestheia developed fulminant hepatitis, patient was exposed to same drug previously. Which is the drug
**Core Concept**
Hepatitis caused by inhalational anesthetics is a rare but serious adverse reaction. The most common anesthetic associated with this condition is a halogenated compound that undergoes biotransformation in the liver, releasing toxic metabolites.
**Why the Correct Answer is Right**
The correct answer is halothane, a halogenated inhalational anesthetic that undergoes cytochrome P450-mediated biotransformation in the liver. This process results in the formation of highly reactive metabolites, such as trifluoroacetic acid and dichloroacetic acid, which can cause hepatotoxicity and trigger an immune response. The patient's previous exposure to the same drug likely sensitizes the immune system, increasing the risk of a severe reaction upon re-exposure.
**Why Each Wrong Option is Incorrect**
* **Option A:** Isoflurane is another halogenated anesthetic, but it is less likely to cause hepatitis due to its lower incidence of biotransformation and the production of toxic metabolites.
* **Option B:** Sevoflurane is also a halogenated anesthetic, but it is less hepatotoxic than halothane and is not commonly associated with fulminant hepatitis.
* **Option C:** Desflurane is a newer halogenated anesthetic with a lower risk of hepatotoxicity due to its lower solubility in blood and tissues, reducing the formation of toxic metabolites.
* **Option D:** Nitrous oxide is a commonly used inhalational anesthetic, but it is not associated with hepatitis or liver toxicity.
**Clinical Pearl / High-Yield Fact**
Halothane hepatitis is a rare but severe adverse reaction that can occur in patients who have been previously exposed to the drug. It is essential to consider this diagnosis in patients who develop fulminant hepatitis after undergoing anesthesia with halogenated anesthetics.
**Correct Answer:** C. Desflurane