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You are here: Home » eGM Resources » Health Information & Resources Portal|Home » RX Drug List (listed alphabetically) » Drug Reference (S's) » Sevoflurane



DESCRIPTION

ULTANE(TM) (sevoflurane), volatile liquid for inhalation, a nonflammable and nonexplosive liquid administered by vaporization, is a halogenated general inhalation anesthetic drug. Sevoflurane is fluoromethyl 2,2,2,-trifluoro-1-(trifluoromethyl) ethyl ether.

Sevoflurane, Physical Constants are:

      Molecular weight 200.05
      Boiling point at 760 mm Hg 58.6oC
      Specific gravity at 20oC 1.520 - 1.525

    Vapor pressure in mm Hg:

        157 mm Hg at 20oC
        197 mm Hg at 25oC
        317 mm Hg at 36oC

Distribution Partition Coefficients at 37oC:

      Blood/Gas 0.63 - 0.69
      Water/Gas 0.36
      Olive Oil/Gas 47 - 54
      Brain/Gas 1.15

Mean Component/Gas Partition Coefficients at 25oC for Polymers Used Commonly in Medical Applications

      Conductive rubber 14.0
      Butyl rubber 7.7
      Polyvinylchloride 17.4
      Polyethylene 1.3

Sevoflurane is nonflammable and nonexplosive as defined by the requirements of International Electrotechnical Commission 601-2-13.

Sevoflurane is a clear, colorless, stable liquid containing no additives or chemical stabilizers. Sevoflurane is nonpungent. It is miscible with ethanol, ether, chloroform and petroleum benzene, and it is slightly soluble in water. Sevoflurane is stable when stored under normal room lighting conditions according to instructions.

Sevoflurane is chemically stable. No discernible degradation occurs in the presence of strong acids or heat. The only known degradation reaction in the clinical setting is through direct contact with CO2 absorbents (soda lime and Baralyme®) producing pentafluoroisopropenyl fluoromethyl ether, (PIFE, C4H2F6O), also known as Compound A, and trace amounts of pentafluoromethoxy isopropyl fluoromethyl ether, (PMFE, C5H6F6O), also known as Compound B.

The production of degradants in the anesthesia circuit results from the extraction of the acidic proton in the presence of a strong base (KOH and/or NaOH) forming an alkene (Compound A) from sevoflurane similar to formation of 2-bromo-2-chloro-1,1-difluoro ethylene (BCDFE) from halothane. Baralyme® causes more production of Compound A than does soda lime. Laboratory simulations have shown that the concentration of these degradants is inversely correlated with the fresh gas flow rate

Sevoflurane degradation in soda lime has been shown to increase with temperature. Since the reaction of carbon dioxide with absorbents is exothermic, this temperature increase will be determined by quantities of CO2 absorbed, which in turn will depend on fresh gas flow in the anesthesia circle system, metabolic status of the patient, and ventilation. The relationship of temperature produced by varying levels of CO2 and Compound A production is illustrated in the following in vitro simulation where CO2 was added to a circle absorber system..

Compound A has been shown to be nephrotoxic in rats after exposures that have varied in duration from one to three hours. No histopathologic change was seen at a concentration of up to 270 ppm for one hour. Sporadic single cell necrosis of proximal tubule cells has been reported at a concentration of 114 ppm after a 3-hour exposure to Compound A in rats. The LC50 reported at 1 hour is 1050-1090 ppm (male-female) and at 3 hours, 350-490 ppm (male-female).

At a fresh gas flow rate of 1 L/min, mean maximum concentrations of Compound A in the anesthesia circuit in clinical settings are approximately 20 ppm (0.002%) with soda lime and 30 ppm (0.003%) with Baralyme® in adult patients; mean maximum concentrations in pediatric patients with soda lime are about half those found in adults. The highest concentration observed in a single patient with Baralyme® was 61 ppm (0.0061%) and 32 ppm (0.0032%) with soda lime. The concentrations of Compound A measured in the anesthesia circuit when sevoflurane is used clinically are not known to be deleterious to humans.

Sevoflurane is not corrosive to stainless steel, brass, aluminum, nickel-plated brass, chrome-plated brass or copper beryllium.





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