Editorial

Tn, Calvey

doi:10.1111/j.1365-2044.1992.tb01999.x

Cited by 21 publications

(2 citation statements)

References 14 publications

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“…5 The enantiomers of local anesthetics may differ in terms of pharmacokinetic and pharmacodynamic properties, with resultant differences in clinical local anesthetic action and toxicity. 12 As the cardiotoxicity of d-bupivacaine is higher than that of the l-enantiomer, 13 the antibacterial properties of the enantiomers may also differ. This would warrant further study.…”

Section: Discussionmentioning

confidence: 99%

Poor Antibacterial Effect of Ropivacaine

1999

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ROPIVACAINE (1-propyl-2Ј,6Ј-pipecoloxylidide) is a long-acting aminoamide local anesthetic that has been introduced into clinical use in the last few years, 1 largely as a replacement for bupivacaine. Bupivacaine has been reported to possess a significant antibacterial effect. [2][3][4] Because data regarding ropivacaine are not available, we compared the antibacterial effects of clinically appropriate concentrations of ropivacaine and bupivacaine in a laboratory setting.

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Section: Discussionmentioning

confidence: 99%

Poor Antibacterial Effect of Ropivacaine

1999

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“…The other enantiomer can have undesirable properties, have different therapeutic activities or be pharmacologically inert. [5–7] It is thus a logical and safer approach to avoid the presence of the therapeutically useless but potentially harmful isomer (‘isomeric ballast’) in drug formulations. [8]…”

Section: Basic Conceptsmentioning

confidence: 99%

Chirality and anaesthetic drugs: A review and an update

Mitra¹,

Chopra²

2011

Indian J Anaesth

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Many molecules can exist as right-handed and left-handed forms that are non-superimposable mirror images of each other. They are known as enantiomers or substances of opposite shape. Such compounds are also said to be chiral (Greek chiros meaning ‘hand’). Such chiral molecules are of great relevance to anaesthetic theory and practice. This review summarizes the basic concepts, pharmacokinetic and pharmacodynamic aspects of chirality, and some specific examples of their application in anaesthesia, along with recent advances to elucidate the anaesthetic mechanisms. Chirality is relevant to anaesthesia, simply because more than half of the synthetic agents used in anaesthesia practice are chiral drugs. Almost all these synthetic chiral drugs are administered as racemic mixture, rather than as single pure enantiomers. These mixtures are not drug formulations containing two or more therapeutic substances, but combination of isomeric substances, with the therapeutic activity residing mainly in one of the enantiomer. The other enantiomer can have undesirable properties, have different therapeutic activities or be pharmacologically inert. Specific examples of application of chirality in anaesthetic drugs include inhalational general anaesthetics (e.g. isoflurane), intravenous anaesthetics (e.g. etomidate, thiopentone), neuromuscular blocking agents (e.g. cisatracurium), local anaesthetics (e.g. ropivacaine and levobupivacaine) and other agents (e.g. levosimendan, dexmedetomidine, L-cysteine). In the recent advances, chirality study has not only helped new drug development as mentioned above, but has also contributed in a more profound way to the understanding of the mechanism of anaesthesia and anaesthetic drugs.

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