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Sevoflurane

 
Drug Info: Sevoflurane

Brand names: Ultane®

Chemical formula:



Sevoflurane inhalation liquid

What is sevoflurane inhalation liquid?

SEVOFLURANE (Ultane®) is used for general anesthesia during surgery and cesarean section. In addition to controlling pain and making you unconscious, general anesthesia control the body's reaction to stress and relieves fear and anxiety associated with surgery. You may receive more than one kind of anesthesia during your surgery or procedure. General anesthesia is commonly used for extensive and long surgeries, but also can be used in shorter and limited procedures. Generic sevoflurane inhalation liquid is not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• a history of malignant hyperthermia
• kidney disease
• liver disease
• myasthenia gravis
• seizure disorder
• an unusual or allergic reaction to sevoflurane, or other anesthetics
• pregnant or trying to get pregnant

How should I use this medicine?

Sevoflurane is given through inhalation (breathing the gas into the lungs) by trained anesthesia professionals in a controlled environment like an operating room. Since there is no one ideal general anesthetic, a combination of drugs that are either injected or inhaled are typically used.

What if I miss a dose?

This does not apply.

What drug(s) may interact with sevoflurane?

• alcohol
amiodarone
• doxapram
disulfiram
• herbal products, including St. John's wort
isoniazid, INH
levodopa
• medicines for colds, breathing difficulties, or weight loss
• medicines for seizures
• medicines that improve muscle strength or tone for conditions like myasthenia gravis
• medicines that reduce high blood pressure, including beta blockers
rifampin
• theophylline
warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking sevoflurane?

You will be closely monitored following anesthesia with sevoflurane.

Sevoflurane can affect your ability to drive or do anything that needs mental alertness for about 24 hours after anesthesia. Do not attempt to drive yourself home if you have received sevoflurane for minor outpatient surgery. You may feel dizzy and lightheaded. To reduce the risk of dizzy or fainting spells, do not sit up or stand up quickly, especially if you are an older patient. Alcohol can make you more drowsy or dizzy; avoid alcoholic drinks for at least 24 hours before and after you receive sevoflurane.

What side effects may I notice from using sevoflurane?

During your surgery or procedure the anesthesiologist will closely monitory all your body systems and treat any serious side effects. Side effects that you should report to your prescriber or health care professional as soon as possible:
• high body temperature
• irregular heartbeat
• low blood pressure
• seizures
• slow or difficult breathing

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• agitation, nervousness
• cough
• difficulty swallowing
• dizziness, drowsiness
• headache
• hoarseness
• increased mouth watering
• low body temperature
• nausea, vomiting
• shivering
• wheezing

Where can I keep my medicine?

This does not apply as you only received general anesthetics in a hospital or clinic setting.


Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

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Veterinary Dictionary: sevoflurane
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A halogenated ether inhalation anesthetic.

Wikipedia: Sevoflurane
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Sevoflurane
Systematic (IUPAC) name
1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy)propane
Identifiers
CAS number 28523-86-6
ATC code N01AB08
PubChem 5206
DrugBank APRD00219
Chemical data
Formula C4H3F7O 
Mol. mass 200.055 g/mol
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life  ?
Excretion  ?
Therapeutic considerations
Pregnancy cat.

?

Legal status

POM(UK) -only(US)

Routes inhaled

Sevoflurane (2,2,2-trifluoro-1-[trifluoromethyl]ethyl fluoromethyl ether), also called fluoromethyl hexafluoroisopropyl ether, is a sweet-smelling, non-flammable, highly fluorinated methyl isopropyl ether used for induction and maintenance of general anesthesia. Together with desflurane, it is replacing isoflurane and halothane in modern anesthesiology[citation needed]. It is often administered in a mixture of nitrous oxide and oxygen. After desflurane it is the volatile anesthetic with the fastest onset and offset.[1] Though desflurane has the lowest blood/gas coefficient of the currently used volatile anesthetics, sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes.

First reports of sevoflurane appeared in the literature in 1971. The agent was developed by scientists at Baxter Laboratories. It was introduced into clinical practice initially in Japan in 1990. The rights for sevoflurane in the US and other countries are held by Abbott Laboratories.

Sevoflurane forms at least two degradation products, Compound A [fluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl ether][2] and Compound B [1,1,1,3,3-pentafluoro-2-(fluoromethoxy)-3-methoxypropane],[3] on contact with the soda lime in a rebreathing apparatus, which absorbs exhaled carbon dioxide, especially at higher temperatures and when the soda lime is desiccated. Compound A has been shown to cause renal necrosis in rats. In humans, direct histological evidence of renal toxicity has not been demonstrated, although there is dose-related proteinuria, glycosuria and enzymuria. During low-flow anaesthesia, when the lower fresh gas flow leads to decreased flushing of the circuit and increased temperature of the soda lime, Compound A may build up to clinically significant levels, although there have never been any reports of adverse events in humans. As a result, sevoflurane is sometimes administered with a minimum fresh gas flow of 2 liters per minute, making it a relatively expensive choice for maintaining general anesthesia. Only two countries currently maintain mandatory minimum flow rates of 2L/min; Canada and Australia. Recent generic competition in select markets has also significantly lowered the unit cost of Sevoflurane, making it more cost effective.

The U.S. Environmental Protection Agency‎ (EPA) has classified sevoflurane as a greenhouse gas, with a global warming potential of 345. One tonne of sevoflurane emitted is equivalent to 345 tonnes of carbon dioxide in the atmosphere.[4]

Sevoflurane has been implicated in neuronal degeneration in infant mice. This activity is thought to occur via blockade of NMDA receptors or hyperactivity of GABA neurotransmission. In this study the researchers showed that exposure of infant mice to inhaled sevoflurane resulted in learning deficits and abnormal social behaviour[5]

Physical properties

Boiling point: 58.6 °C (at 101.325 kPa)
Density: 1.517–1.522 g/cm³ (at 20 °C)
MAC : 2 vol %
Molecular Weight: 200 u
Vapor pressure: 157 mmHg (20.9 kPa) (at 20 °C)
197 mmHg (26.3 kPa) (at 30 °C)
317 mmHg (42.3 kPa) (at 36 °C)
Blood:Gas Partition Coefficient: 0.68
Oil:Gas Partition Coefficient: 47


References

  1. ^ Sakai EM, Connolly LA, Klauck JA (December 2005). "Inhalation anesthesiology and volatile liquid anesthetics: focus on isoflurane, desflurane, and sevoflurane". Pharmacotherapy 25 (12): 1773–88. doi:10.1592/phco.2005.25.12.1773. PMID 16305297. http://www.atypon-link.com/doi/abs/10.1592/phco.2005.25.12.1773. 
  2. ^ Stabernack CR, Eger EI 2nd, Warnken UH, Förster H, Hanks DK, Ferrell LD. (2003). "Sevoflurane degradation by carbon dioxide absorbents may produce more than one nephrotoxic compound in rats". Can J Anaesth 50 (3): 249-52. 
  3. ^ Schmidt, R.; Roeder, M.; Oeckler, O.; Simon, A.; Schurig, V. (2000). "Separation and absolute configuration of the enantiomers of a degradation product of the new inhalation anesthetic sevoflurane". Chirality 12 (10)): 751-755. 
  4. ^ "Mandatory Greenhouse Gas Reporting, Proposed Rule.", Federal Register 74:68 (10 April 2009) p. 16629-16630 (Proposed 40 CFR 98, Subpart A, Table A-1)
  5. ^ http://www.ncbi.nlm.nih.gov/pubmed/19212262?ordinalpos=8itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

External links


 
 
Learn More
Sevoflurane inhalation liquid
Sevoflurane Inhalation vapour, liquid
Abbott Laboratories

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Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Sevoflurane" Read more