How is sevoflurane metabolized and eliminated from the body?
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How is sevoflurane metabolized and eliminated from the body?
In humans, 2% to 5% of the absorbed dose of sevoflurane is metabolized by the liver, resulting in the formation of inorganic fluoride and the organic fluoride metabolite hexafluoroisopropanol 41. The latter is conjugated with glucuronic acid and excreted rapidly via the kidneys.
Does sevoflurane cause nephrotoxicity?
Sevoflurane has been associated with nephrotoxicity in previous animal studies, but it is now accepted that these results have no clinical significance in human subjects [18] . … Sevoflurane is metabolized into two products, inorganic fluoride ions and compound A with potential nephrotoxicity.
Where is sevoflurane metabolized?
human liver microsomes
Sevoflurane is metabolized to free fluoride and hexafluoroisopropanol (HFIP). Cytochrome P450 2E1 is the major isoform responsible for sevoflurane metabolism by human liver microsomes in vitro. This investigation tested the hypothesis that P450 2E1 is predominantly responsible for sevoflurane metabolism in vivo.
What are the possible side effects of sevoflurane?
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- Blurred vision.
- chest pain, tightness, or discomfort.
- choking.
- fast, pounding, or irregular heartbeat or pulse.
- lightheadedness, dizziness, or fainting.
- slow or irregular heartbeat.
- unable to speak.
- unusual tiredness or weakness.
How is isoflurane sevoflurane excreted by the body?
Similar to uptake, the elimination of a given vol- atile anaesthetic is related to its solubility in blood and tissues (figures 5 and 6). Between 95 and 98% of the amount of sevoflurane taken up is eliminated through the lungs.
How is inhaled anesthetic metabolized?
Excretion of the end product is through the kidneys, hepatobiliary system, or lungs. 6 Less than 5% of inhaled anesthetic is metabolized in the body and the elimination predominantly is through lungs, i.e. alveolus.
How long does sevoflurane stay in your system?
Time Constants and Brain Equilibration
| Time constant | Brain Equilibration time | |
|---|---|---|
| Isoflurane | 3-4 mins | 10-15 mins |
| Sevoflurane | 2 mins | 6 mins |
| Desflurane | 2 mins | 6 mins |
| Nitrous Oxide | 2 mins | 6 mins |
How does anesthesia affect the kidneys?
Inhalational anaesthetics generally reduce glomerular filtration rate and urine output, mainly by extra-renal effects that are attenuated by pre-operative hydration. Opioids, barbiturates and benzodiazepines also reduce glomerular filtration rate and urine output.
Does isoflurane cause nephrotoxicity?
Both have comparable potency and easy titratability but sevoflurane has lower pungency and results in faster patient recovery. Isoflurane, however, is more affordable. The nephrotoxicity of sevoflurane is undisputed but studies on isoflurane nephrotoxicity are lacking.
Can sevoflurane cause malignant hyperthermia?
Its low blood-gas partition coefficient allows rapid induction of and fast recovery from anesthesia. 1However, sevoflurane is also a triggering agent for malignant hyperthermia (MH), a potentially fatal hypermetabolic syndrome of skeletal muscle.
Is isoflurane metabolized by liver?
ISOFLURANE is metabolized by human hepatic cytochrome P450 to a reactive acyl halide metabolite [1]capable of trifluoroacetylating liver proteins.
How are volatile anesthetics metabolized?
Metabolism of volatile anaesthetics can take place by numerous different mechanisms which include oxidation, reduction, dehalogenation, hy- drolysis and synthesis or conjugation. In most inci- dences in vivo detoxification is of value in protecting the body from a variety of xenobiotic agents.
Which anesthetic agent is nephrotoxic?
Furthermore, sevoflurane can impair kidney function; the inorganic fluoride ions resulting from its defluorination and the production of compound A from the reaction with carbon dioxide absorbent have been associated with nephrotoxicity [28, 29].
