Summary
Alfathesin is a new intravenous anaesthetic agent. It is a mixture of two steroids, alphaxalone and alphadolone acetate in a ratio of 3: 1; dissolved in an aqueous vehicle containing 20 % polyoxyethylated castor oil. Alphadolone acetate has only about half the anaesthetic activity of alphaxalone but is necessary to enhance the solubility of alphaxalone.
Clinical and pharmacological studies have shown Alfathesin to have a rapid onset of action and a short duration in lower doses. A single dose of 50 µ/kg has about the same anaesthetic potency as thiopentone 5 mg/kg given under the same conditions. Unlike the barbiturates, Alfathesin is rapidly cleared from the plasma; alphaxalone is conjugated in the liver and does not rely on redistribution in tissue and fat for its elimination. As a result, patients tend to recover more clear-headed than with thiopentone. Recovery is not as much delayed after incremental doses as with the barbiturates. Alfathesin has been used successfully for induction of anaesthesia which is maintained with other drugs. Cardiorespirator effects are similar to those after approximately equipotent analgesic doses of thiopentone. The incidence of venous sequelae is less than with 5 % thiopentone, 2 % methohexitone or propanidid, but similar to that with dilute barbiturate solutions.
Involuntary muscle movements are the commonest unwanted effects, especially after higher doses or when hyoscine is used for premedication.
Similar content being viewed by others
References
Andrew, D.S.; Chow, A.E.; Copions, M.P. and Green, R.A.: Althesin for dental anaesthesia in children. A comparison with methohexitone sodium. Journal ofDentistry 1:235(1973).
Arora, M.V.; Carson, I.W. and Dundee, J.W.: Alterations in response to somatic pain associated with anaesthesia. XXI: Althesin (CT 1341). British Journal of Anaesthesia 44: 590(1972).
Austin, T.R.; Anderson, J. and Richardson, J.: Bron-chospasm following Althesin anaesthesia. British Medical Journal 2: 661 (1973).
Avery, A.F. and Evans, A.: Reactions to Althesin. British Journal of Anaesthesia 45: 301 (1973).
Bradford, Elizabeth M.W.; Miller, D.C.; Campbell, D. and Baird, W.L.M.: CT 1341).: Interaction with some anaesthetic agents. Brit. J. Anaesth. 43: 940 (1971).
Campbell, D; Miller, D.C. and Bradford, Elizabeth M.W.: Althesin: further studies of interaction with anaesthetic agents. Postgraduate Medical Journal 48 (Suppl. 2): 123(1972).
Card, Barbara; McCulloch, R.J. and Pratt, D.A.H.: Tissue distribution of CT 1341 in the rat; an autoradiographic study. Postgraduate Medical Journal 48 (Suppl. 2): 34(1972).
Carson, I.W.: Group trial of Althesin as an intravenous anaesthetic. Postgraduate Medical Journal 48 (Suppl. 2): 108(1972).
Carson, I.W.; Alexander, J.P.; Hewitt, J.C. and Dundee, J.W.: Clinical studies of induction agents. XLI: Venous sequelae following the use of the steroid anaesthetic agent, Althesin. British Journal of Anaesthesia 44: 1311(1972).
Child, K.J.; Currie, J.P.; Davis, B.; Dodds, M.G.; Pearce, D.R. and Twissell, D.J.: The pharmacological properties in animals of CT 1341 — a new steroid anaesthetic agent. British Journal of Anaesthesia 43: 2(1971).
Child, K.J.; English, A.F.; Gilbert, H.G. and Woollen, E.A.: An endocrinological evaluation of Althesin (CT 1341 ) with special reference to reproduction. Postgraduate Medical Journal 48 (Suppl. 2): 57 (1972b).
Child, K.J.; Gibson, W.; Harnby, G. and Hart, J.W.: Metabolism and excretion of Althesin (CT 1341 ) in the rat. Postgraduate Medical Journal 48 (Suppl. 2): 37 (1972a).
Clarke, R.S.J.; Dundee, J.W. and Carson, I.W.: A new steroid anaesthetic — Althesin. Proceedings of the Royal Society of Medicine 66: 1027 (1973).
Clarke, R.S.J.; Dundee, J.W.; Carson, I.W.; Arora, M.V. and McCaughey, W.: Clinical studies of induction agents. XL: Althesin with various premedicants. British Journal of Anaesthesia 44: 845 (1972b).
Cohen, R.S.; Creighton, R.E.; Nisbet, H.I.A.; McDonald, P. and Steward, D.J.: The effects of Althesin on cerebral blood flow and intracranial pressure. Canadian Anaesthetists’ Society Journal 20: 754 (1973).
Cohen, R.S.; Nisbet, H.I.A.; Creighton, R.E.; Steward, D.J. and McDonald, P.: The effects of hypoxaemia on cerebral blood flow and cerebrospinal fluid pressure in dogs anaesthetized with Althesin, pentobarbitone and methoxyflurane. Canadian Anaesthetists’ Society Journal 20: 757 (1973b).
Coleman, A.J.; Downing, J.W.; Leary, W.P.; Moyes, D.G. and Styles, M.: The immediate cardiovascular effects of Althesin (Glaxo CT 1341 ), a steroid induction agent, and thiopentone in man. Anaesthesia 27: 373(1972).
Cooper, J.: Althesin in out-patient psychiatric practice. Postgraduate Medical Journal 48 (Suppl. 2): 115 (1972).
Crowther, A.N.: Bronchospasm following Althesin anaesthesia. British Medical Journal 2: 775 (1973).
Dodds, M.G. and Twissell, DJ.: Effect of Althesin (CT 1341 ) on circulatory responses to adrenaline and on halothane-adrenaline cardiac dysrhythmias in the cat. Postgraduate Medical Journal 48 (Suppl. 2): 17(1972).
Du Cailar, J.: The effects in man of infusions of Althesin with particular regard to the cardiovascular system. Postgraduate Medical Journal 48 (Suppl. 2): 72 (1972).
Dundee, J.W.; Assem, E.S.K.; Gaston, J.M.; Keitty, S.R.; Sutton, J.A.; Clarke, R.S.J. and Grainger, D: Sensitivity to intravenous anaesthetics: A report of three cases. British Medical Journal 1: 63 (1974).
Foëx, P. and Prys-Roberts, C: Pulmonary haemo-dynamics and myocardial effects of Althesin (CT 1341 ) in the goat. Postgraduate Medical Journal 48 (Suppl. 2): 24(1972).
Foley, Eleanor I.; Walton, B.; Savege, T.M.; Strunin, L. and Simpson, B.R.: A comparison of recovery times between Althesin and methohexitone following anaesthesia for electro-convulsive therapy. Postgraduate Medical Journal 48 (Suppl. 2): 112 (1972).
Fordham, R.M.M.; Awdry, P.N. and Paterson, G.M.: The suitability of Althesin for use as an induction agent in intra-ocular surgery. Postgraduate Medical Journal 48 (Suppl. 2): 129(1972).
Gilbert, H.G.; Woollen, E.A. and Child, K.J.: Reproduction in rabbits given Althesin. Journal of Reproduction and Fertility 34: 519 (1973).
Hall, G.M.; Whitwam, J.G. and Morgan, M.: Some respiratory effects of Althesin. British Journal of Anaesthesia 45: 629 (1973).
Hannington-Kiff, J.G.: Comparative recovery rates following induction of anaesthesia with Althesin and methohexitone in out-patients. Postgraduate Medical Journal 48 (Suppl. 2): 116 (1972).
Harrison, S.G.C. and Sellick, B.A.: Cardiovascular effects of Althesin in patients with cardiac pathology. British Journal of Anaesthesia 44: 1205 (1972).
Healy, T.E.J.: Bronchospasm following Althesin induction. British Medical Journal 2: 975 (1973).
Healy, T.EJ.; Birmingham, A.T. and Chatterjee, S.C.: A comparison of the effect of induction of anaesthesia by thiopentone or Althesin on the duration of action of suxamethonium. Postgraduate Medical Journal 48 (Suppl. 2): 90 (1972).
Heinonen, J.; Riitta, Orko and Louhija, A.: Anaesthesia for cardioversion: A comparison of Althesin and thiopentone. British Journal of Anaesthesia 45: 49 (1973).
Horton, J.N.: Adverse reaction to Althesin. Anaesthesia 28: 182(1973).
Hunter, A.R.: Advances in anaesthesia. Practitioner 211: 476 (1973).
Jedeikin, R.J. and Kaye, S.E.: Clinical studies with Althesin (CT 1341 ) in minor operative procedures. South African Medical Journal 47: 129 (1973).
Kavan, Eva M.; Julien, R.M. and Elliott, H.W.: Central nervous system effects of Althesin (CT 1341 ): a new steroid anaesthetic agent. Canadian Anaesthetists’ Society Journal 20: 528 (1973).
Leary, W.P.; Coleman, A.J.; Downing, J.W. and Moyes, D.G: The immediate cardiovascular effects of Glaxo CT 1341, a steroid induction agent, in man. South African Medical Journal 46: 877 (1972).
Metha, S.: Anaphylactic reaction to Althesin. Anaesthesia 28: 669(1973).
Miller, D.C.; Bradford, Elizabeth M.W. and Campbell, D: Haemodynamic effects of Althesin in poor-risk patients. Postgraduate Medical Journal 48 (Suppl. 2): 133(1972).
Morgan, M.; Whitwam, J.G. and Page, P.: Influence of subnarcotic dose of Althesin (CT 1341 ) on pain induced by two types of pain stimulus. British Journal of Anaesthesia 45: 481 (1973).
Notcutt, W.G.: Adverse reaction to Althesin. Anaesthesia 25:673(1973).
Patschke, D.; Bruckner, J.B.; Reinecke, A.; Schmicke, P.; Tarnow, J. and Eberlein, HJ.: Experimentelle Untersuchungen der Kreislaufwirkungen von CT 1341, einem neuen Steroidanaestheticum. Der Anaesthesist 21: 338 (1972).
Pickerodt, V.; McDowall, D.G.; Coroneos, N.J. and Keaney, N.P.: Effect of Althesin on carotid blood flow and intracranial pressure in the anaesthetized baboon: a preliminary communication. Postgraduate Medical Journal 48 (Suppl. 2): 58 (1972).
Prys-Robert, C; Foëx, P. and Biro, G.P.: Cardiovascular responses of hypertensive patients to induction of anaesthesia with Althesin. Postgraduate Medical Journal 48 (Suppl. 2): 80(1972).
Rawstron, R.E.; McNeill, T.D.M. and Scott, R.M.: CT/1341: A steroid anaesthetic induction agent. Australian and New Zealand Journal of Surgery 42: 206 (1972).
Savege, T.M.; Blogg, C.E.; Foley, Eleanor L; Ross, L.; Lang, M. and Simpson, B.R.: The cardiorespiratory effects of Althesin and Ketamine. Anaesthesia 28: 391 (1973a).
Savege, T.M.; Foley, Eleanor I.; Ross, L. and Maxwell, M.P.: A comparison of the cardiorespiratory effects during induction of an anaesthesia of Althesin with thiopentone and methohexitone. Postgraduate Medical Journal 48 (Suppl. 2): 66 (1972).
Savege, T.M.; Foley, Eleanor I. and Simpson, B.R.: Some cardiorespiratory effects of cremophor EL in man. British Journal of Anaesthesia 45: 515 (1973b).
Schooness, J.A. and Kok, O.V.S.: Althesin (CT 1341 ) — a new intravenous anaesthetic agent. South African Medical Journal 47: 10(1973).
Scott, D.F. and Virden, Susan: Comparison of the effect of Althesin with other induction agents on electroencephalographic patterns. Postgraduate Medical Journal 48 (Suppl. 2): 93 (1972).
Sonntag, H.; Schenk, H.; Regensburger, D.; Kettler, D.; Hellberg, K; Knoll, D.; Donath, U. and Becker, H.: Effects of Althesin (Glaxo CT 1341 ) on coronary blood flow and myocardial metabolism in man. Acta anaesthesiologica Scandinavica 17: 218 (1973).
Swerdlow, M.: Studies with Althesin — a new steroid anaesthetic. Postgraduate Medical Journal 48 (Suppl. 2): 105(1972).
Swerdlow, M.: Althesin — a new intravenous anaesthetic. Canadian Anaesthetists’ Society Journal 20: 186 (1973).
Takahashi, T.; Takasaki, M.; Namiki, A. and Dohi, S.: Effects of Althesin on cerebrospinal fluid pressure. British Journal of Anaesthesia 45: 179 (1973).
Tammisto, T.; Takki, S.; Tigerstedt, I. and Kauste, A.: A comparison of Althesin and thiopentone in induction of anaesthesia. British Journal of Anaesthesia 45: 100(1973).
Turner, J.M.; Coroneos, N.J.; Gibson, R.M.; Powell, D.; Ness, M.A. and McDowall, D.G.: The effect of Althesin on intracranial pressure in man. British Journal of Anaesthesia 45: 168 (1973).
Ungerer, M.J.; Erasmus, F.R. and Muller, F.O.: Evaluation of Althesin (CT 1341 ) as an intravenous induction agent. South African Medical Journal 47: 783 (1973).
Uppington, J.: Epileptiform convulsion with Althesin. Anaesthesia 28: 546(1973).
Warren, J.B.: Althesin in the dental chair. Postgraduate Medical Journal 48 (Suppl. 2): 130 (1972).
Author information
Authors and Affiliations
Additional information
See subject index in this issue for further indexing terms.
Rights and permissions
About this article
Cite this article
Brogden, R.N., Speight, T.M. & Avery, G.S. Alfathesin (‘Althesin’ — Glaxo): An Independent Report. Drugs 8, 87–108 (1974). https://doi.org/10.2165/00003495-197408020-00003
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-197408020-00003