Drug Index


Mechanism :

Sevoflurane induces a reduction in junctional conductance by decreasing gap junction channel opening times and increasing gap junction channel closing times. Sevoflurane also activates calcium dependent ATPase in the sarcoplasmic reticulum by increasing the fluidity of the lipid membrane. It also appears to bind the D subunit of ATP synthase and NADH dehydrogenase and also binds to the GABA receptor, the large conductance Ca2+ activated potassium channel, the glutamate receptor, and the glycine receptor.

Indication :

  • Induction and maintenance of general anesthesia

Contraindications :

Hypersensitivity to drug/class/component, Malignant hyperthermia history.

Caution if hepatic impairment, Cr >1.5, seizure history or risk, head injury, ICP increase, QT prolongation, neuromuscular disease.

Dosing :

General anesthesia induction and maintenance:
Titrate inhalation to effect. Suitable for mask induction. Give with 100% oxygen.
0-1 months: Induction 3.3% and maintenance 3.5%
1-6 months: Induction 3% and maintenance 3%
6 months to <3 years: Induction 2.8% and maintenance 2.8%
3-12 years: Induction 2.5% and maintenance 2.5%
12-25 years: Induction 2.1% and maintenance 2.1%

Adverse Effect :

Serious Reactions: Malignant hyperthermia, apnea, hyperkalemia, arrhythmias, seizures, hepatotoxicity, increase ICP, anaphylactoid reaction, bronchospasm, airway obstruction, cardiac arrest.

Common Reactions: Nausea/vomiting, agitation, cough, hypotension, laryngospasm, breath holding, bradycardia, tachycardia, airway obstruction, somnolence, shivering, sialorrhea, dizziness, hypertension, apnea.

Interaction :

Avoid/Use Alternative:
Amikacin, Aminophylline, Bedaquiline, Clarithromycin, Doxylamine, Gentamicin, Kanamycin, Methadone, Neomycin, Paromomycin, Pasireotide, Pimozide, Streptomycin, Theophylline, Tobramycin.
Monitor/Modify Treatment:
Acebutolol, Amphetamine, Atenolol, Atracurium, Benzphetamine, Betaxolol, Bisoprolol, Canagliflozin, Carvedilol, Ciprofloxacin, Cisatracurium, Dexmedetomidine, Dextroamphetamine, Dobutamine, Dopamine, Doxapram, Ephedra, Ephedrine, Epinephrine, Esmolol, Isoproterenol, Labetalol, Lisdexamfetamine, Methamphetamine, Metoprolol, Nadolol, Nebivolol, Norepinephrine, Pancuronium, Penbutolol, Phenylephrine Injection, Pindolol, Propranolol, Quinidine (CYP2D6 booster), Riociguat, Rocuronium, Sotalol, Timolol, Tramadol, Trandolapril, Vancomycin, Vecuronium.

Hepatic Dose :

Mild-Moderate hepatic impairment: Dose adjustment guidelines are not available. Dose adjustment may be required. Use caution when administering, and monitor liver function closely.
Severe hepatic impairment: Effect has not been studied; use is not recommended.
01/21/2024 08:56:18 Sevoflurane
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