Acute renal failure and rise in alkaline phosphatase activity caused by cimetidine.

In nearly 14 000 administrations of Althesin the senior author of this paper (RL) has seen only two severe adverse reactions. These were in children of 5 and 6 years old after a second maxillary antral washout for chronic sinusitis within three weeks. The reaction occurred immediately and was manifested by pronounced pallor and cardiovascular collapse with pronounced tachycardia but no bronchospasm. Both cases responded satisfactorily to intravenous administration of chiorpheniramine and hydrocortisone and ventilation with oxygen. Administering Althesin to other patients, we have observed a very low incidence of minor reactions such as flushing of the neck and shoulder region, coughing, hiccups, and limb movements. The patient discussed here, however, showed no adverse reactions, either of hypersensitivity or of untoward movement or coughing (obviously particularly important during a microltyngoscopic procedure). The patient had the endoscopic procedures performed on a day-case basis without analesia. Throughout this time she has continued full schooling and is now at university. Althesin has been shown to be rapidly cleared from the plama in animals and subsequently eliminated.3 Clinical events in this case suggest that this is so in man and makes Althesin a good choice where repeated general anaesthetics may be necessary.