Sevoflurane
Generic Name
Sevoflurane Solution for Inhalation
Manufacturer
Various manufacturers worldwide
Country
Globally manufactured
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sevoflurane 100 v solution for inhalation | ৳ 21,000.00 | N/A |
Description
Overview of the medicine
Sevoflurane is a non-flammable, volatile liquid used for inhalation anesthesia. It is administered via a calibrated vaporizer and is widely used for induction and maintenance of general anesthesia in adults and pediatric patients due to its rapid onset and recovery profile.
Uses & Indications
Dosage
Adults
Induction: 0.5-5% sevoflurane in oxygen or nitrous oxide/oxygen mixture, titrate to effect. Maintenance: 0.5-3% sevoflurane.
Elderly
Lower concentrations are typically required. MAC (Minimum Alveolar Concentration) decreases with age. Reduce dosage by 25-50%.
Renal_impairment
Use with caution. Although metabolism is minimal, accumulation of inorganic fluoride ions may be a concern with prolonged exposure or severe impairment, but typically not clinically significant for standard surgical durations.
How to Take
Administered by trained anesthesiologists or other qualified healthcare professionals using a calibrated vaporizer specifically designed for sevoflurane, delivering the vaporized agent via a mask or endotracheal tube.
Mechanism of Action
Sevoflurane works by enhancing the activity of GABA-A receptors, inhibiting NMDA receptors, and affecting ion channels (e.g., potassium channels) in the central nervous system. These actions lead to decreased neuronal excitability, resulting in muscle relaxation, analgesia, and loss of consciousness.
Pharmacokinetics
Onset
Rapid, typically within 1-2 minutes for induction.
Excretion
Primarily excreted unchanged through the lungs (approximately 95%). A small portion of metabolites (fluoride ions) are renally excreted.
Half life
Not directly applicable in the same way as IV drugs; rapid elimination largely unchanged via the lungs. Plasma elimination half-life of fluoride ion metabolites is approximately 24 hours.
Absorption
Rapidly absorbed through the lungs; blood/gas partition coefficient of 0.59.
Metabolism
Minimal hepatic metabolism (<5%) by cytochrome P450 2E1 to hexafluoroisopropanol (HFIP) and inorganic fluoride. HFIP is rapidly glucuronidated.
Side Effects
Contraindications
- Known hypersensitivity to sevoflurane or other halogenated agents.
- History or genetic predisposition to malignant hyperthermia.
- Patients in whom general anesthesia is contraindicated.
- Patients with known or suspected susceptibility to skeletal muscle relaxant-induced hyperkalemia (e.g., Duchenne muscular dystrophy).
Drug Interactions
Nitrous Oxide
Reduces the MAC of sevoflurane, allowing lower concentrations to be used.
Opioids/Benzodiazepines
Potentiate the anesthetic effects, requiring lower sevoflurane concentrations.
Non-depolarizing Muscle Relaxants
Sevoflurane potentiates the effect of non-depolarizing muscle relaxants; dosage reduction may be necessary.
Beta-blockers/Calcium Channel Blockers
May exacerbate myocardial depression and hypotension.
Storage
Store at controlled room temperature (20-25°C), protected from light. Keep container tightly closed when not in use. Do not store in direct sunlight.
Overdose
Overdose presents as profound respiratory and/or circulatory depression. Management involves discontinuing sevoflurane, establishing a patent airway, initiating assisted or controlled ventilation with 100% oxygen, and maintaining cardiovascular function with appropriate measures.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm. Use during pregnancy only if clearly needed. Caution should be exercised when administered to a nursing mother, as it is unknown if sevoflurane or its metabolites are excreted in human milk.
Side Effects
Contraindications
- Known hypersensitivity to sevoflurane or other halogenated agents.
- History or genetic predisposition to malignant hyperthermia.
- Patients in whom general anesthesia is contraindicated.
- Patients with known or suspected susceptibility to skeletal muscle relaxant-induced hyperkalemia (e.g., Duchenne muscular dystrophy).
Drug Interactions
Nitrous Oxide
Reduces the MAC of sevoflurane, allowing lower concentrations to be used.
Opioids/Benzodiazepines
Potentiate the anesthetic effects, requiring lower sevoflurane concentrations.
Non-depolarizing Muscle Relaxants
Sevoflurane potentiates the effect of non-depolarizing muscle relaxants; dosage reduction may be necessary.
Beta-blockers/Calcium Channel Blockers
May exacerbate myocardial depression and hypotension.
Storage
Store at controlled room temperature (20-25°C), protected from light. Keep container tightly closed when not in use. Do not store in direct sunlight.
Overdose
Overdose presents as profound respiratory and/or circulatory depression. Management involves discontinuing sevoflurane, establishing a patent airway, initiating assisted or controlled ventilation with 100% oxygen, and maintaining cardiovascular function with appropriate measures.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of fetal harm. Use during pregnancy only if clearly needed. Caution should be exercised when administered to a nursing mother, as it is unknown if sevoflurane or its metabolites are excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, refer to manufacturer's specific product labeling.
Availability
Hospitals, Clinics, and Specialized Medical Facilities
Approval Status
Approved by FDA and many international regulatory bodies
Patent Status
Expired, available generically
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials for its efficacy and safety across various surgical procedures and patient populations, including pediatrics and geriatrics.
Lab Monitoring
- Continuous monitoring of vital signs (heart rate, blood pressure, oxygen saturation, end-tidal CO2)
- ECG
- Fluid balance
- Temperature monitoring
- Electrolytes (if clinically indicated).
Doctor Notes
- Monitor for signs of malignant hyperthermia; have dantrolene readily available.
- Caution in patients with elevated intracranial pressure, as sevoflurane can increase cerebral blood flow.
- Careful titration is crucial, especially in patients with cardiovascular compromise.
Patient Guidelines
- Patients should adhere to pre-anesthetic fasting instructions.
- Inform the anesthesiologist about all medications, supplements, and pre-existing medical conditions.
- Understand potential post-operative effects like dizziness or nausea.
Missed Dose Advice
Not applicable as sevoflurane is administered in a controlled medical setting by healthcare professionals during a scheduled procedure.
Driving Precautions
Patients should not drive or operate heavy machinery for at least 24 hours after receiving sevoflurane anesthesia due to potential residual drowsiness and impaired cognitive function.
Lifestyle Advice
- Avoid alcohol and smoking prior to surgery as advised by the healthcare team.
- Ensure adequate rest before the procedure.
- Follow post-operative care instructions carefully.
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International brand names for this medicine. Click a brand to search for detailed information.