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SUPRANE is a brand name for Desflurane, supplied as a liquid. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: SUPRANE (desflurane) is indicated as an inhalation agent for maintenance of general anesthesia following induction with agents other than SUPRANE (desflurane) in adults. SUPRANE (desflurane) is not recommended for mask induction of anesthesia in adults because of a high incidence of moderate to severe upper airway…
Verbatim from this product's HC label. Tap a section to expand.
1 Dosing Considerations • Issues such as whether or not to premedicate and the choice of premedicant(s) must be individualized. v. pre-anesthetic medication, such as opioids and/or benzodiazepines. • SUPRANE (desflurane) is potentiated by benzodiazepine sedatives and opioids (see 9 DRUG INTERACTIONS).
• Nitrous oxide diminishes the inspired concentration of SUPRANE (desflurane) required to reach a desired level of anesthesia (see Table 1). • SUPRANE (desflurane) decreases the required doses of neuromuscular blocking agents. If added relaxation is required, supplemental doses of muscle relaxants may be used.
(See Table 6) • SUPRANE (desflurane) is not recommended for mask induction as it causes a high incidence of laryngospasm, coughing, secretions, breath holding, apnea, increase in secretions and oxyhemoglobin desaturation (see 8 ADVERSE REACTIONS).
5-1 MAC, whether the carrier gas is O2 or N2O/O2. • No dosage adjustments are required in patients with renal and hepatic impairment. 4 Abnormal Laboratory Findings: Hematologic, Clinical Chemistry and Other Quantitative Data). • Blood pressure and heart rate should be monitored carefully during maintenance as part of the evaluation of depth of anesthesia.
• In patients with coronary artery disease, maintenance of normal hemodynamics is important to avoid myocardial ischemia. SUPRANE (desflurane) should not be used as the sole anesthetic in patients with or at risk of coronary artery disease or in patients where increases in heart rate or blood pressure are undesirable.
Rapid inhaled induction of anesthesia with SUPRANE (desflurane) alone, without concomitant administration of an opioid, in patients with coronary artery disease, has been associated with an increased incidence of myocardial ischemia.
SUPRANE (desflurane), when given in conjunction with opioids for maintenance of anesthesia in patients with coronary artery disease, has not produced an incidence of ischemia different from that produced by other anesthetics. Thus, when SUPRANE (desflurane) is to be used in patients with coronary artery disease, it should always be used in combination with other medications, such as intravenous opioids or hypnotics, and it should not be used for induction (see 10 CLINICAL PHARMACOLOGY).
5% SUPRANE (desflurane) with or without the concomitant use of nitrous oxide.
). 5-1 MAC, whether the carrier gas is O2 or N2O/O2. • No dosage adjustments are required in patients with renal and hepatic impairment. 4 Abnormal Laboratory Findings: Hematologic, Clinical Chemistry and Other Quantitative Data). • Blood pressure and heart rate should be monitored carefully during maintenance as part of the evaluation of depth of anesthesia.
• In patients with coronary artery disease, maintenance of normal hemodynamics is important to avoid myocardial ischemia. SUPRANE (desflurane) should not be used as the sole anesthetic in patients with or at risk of coronary artery disease or in patients where increases in heart rate or blood pressure are undesirable.
Rapid inhaled induction of anesthesia with SUPRANE (desflurane) alone, without concomitant administration of an opioid, in patients with coronary artery disease, has been associated with an increased incidence of myocardial ischemia.
SUPRANE (desflurane), when given in conjunction with opioids for maintenance of anesthesia in patients with coronary artery disease, has not produced an incidence of ischemia different from that produced by other anesthetics. Thus, when SUPRANE (desflurane) is to be used in patients with coronary artery disease, it should always be used in combination with other medications, such as intravenous opioids or hypnotics, and it should not be used for induction (see 10 CLINICAL PHARMACOLOGY).
5% SUPRANE (desflurane) with or without the concomitant use of nitrous oxide.
Pediatrics:
SUPRANE (desflurane) should not be used for maintenance of anesthesia in non- intubated pediatric patients due to an increased incidence of respiratory adverse reactions, including coughing, laryngospasm and secretions, especially with removal of the laryngeal mask airway (LMA) under deep anesthesia in patients 6 years old or younger.
, Hepatic/Biliary/Pancreatic). • Known or suspected genetic susceptibility to malignant hyperthermia or in patients with a history of malignant hyperthermia (see 7 WARNINGS AND PRECAUTIONS, Malignant Hyperthermia (MH)). 1 Pediatrics).
3 Pediatrics). 1 Dosing Considerations • Issues such as whether or not to premedicate and the choice of premedicant(s) must be individualized. v. pre-anesthetic medication, such as opioids and/or benzodiazepines. • SUPRANE (desflurane) is potentiated by benzodiazepine sedatives and opioids (see 9 DRUG INTERACTIONS).
• Nitrous oxide diminishes the inspired concentration of SUPRANE (desflurane) required to reach a desired level of anesthesia (see Table 1). • SUPRANE (desflurane) decreases the required doses of neuromuscular blocking agents. If added relaxation is required, supplemental doses of muscle relaxants may be used.
(See Table 6) • SUPRANE (desflurane) is not recommended for mask induction as it causes a high incidence of laryngospasm, coughing, secretions, breath holding, apnea, increase in secretions and oxyhemoglobin desaturation (see
2 Clinical Trial Adverse Reactions). 2 Geriatrics (> 65 years of age) The minimum alveolar concentration (MAC) of SUPRANE (desflurane) decreases with increasing patient age. 4 Geriatrics). 2 CONTRAINDICATIONS • When general anesthesia is contraindicated.
• Known sensitivity to SUPRANE (desflurane), other halogenated anesthetics, or component of the container. For a complete listing, see the 6 DOSAGE FORMS, COMPOSITION AND PACKAGING section of the product monograph. • Patients with a history of hepatitis due to a halogenated inhalational anesthetic or in whom liver dysfunction, jaundice or unexplained fever, leucocytosis, or eosinophilia has occurred after a previous halogenated anesthetic administration (see 7 WARNINGS AND PRECAUTIONS, Hepatic/Biliary/Pancreatic).
• Known or suspected genetic susceptibility to malignant hyperthermia or in patients with a history of malignant hyperthermia (see 7 WARNINGS AND PRECAUTIONS, Malignant Hyperthermia (MH)). 1 Pediatrics). SUPRANE (desflurane, USP) Page 5 of 54
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Pediatrics:
SUPRANE (desflurane) should not be used for maintenance of anesthesia in non- intubated pediatric patients due to an increased incidence of respiratory adverse reactions, including coughing, laryngospasm and secretions, especially with removal of the laryngeal mask airway (LMA) under deep anesthesia in patients 6 years old or younger.
The safety of SUPRANE (desflurane) has not been investigated in non-intubated pediatric patients younger than 2 years of age due to increased incidence of respiratory events observed in the 2 – 16 year age group. 2-10% SUPRANE (desflurane) in children with or without the concomitant use of nitrous oxide.
Geriatrics:
Geriatric patients require approximately 70% the adult dose in 100% oxygen and approximately 40% the adult dose in 60% nitrous oxide. SUPRANE (desflurane, USP) Page 7 of 54 During the maintenance of anesthesia with inflow rates of 2 L/min or more, the alveolar concentration of SUPRANE (desflurane) will usually be within 10% of the inspired concentration.
During the maintenance of anesthesia, increasing concentrations of SUPRANE (desflurane) produce dose-dependent decreases in blood pressure. Excessive decreases in blood pressure may be due to depth of anesthesia and in such instances may be corrected by decreasing the inspired concentration of SUPRANE (desflurane).
Concentrations of SUPRANE (desflurane) exceeding 1 MAC may increase heart rate. Thus with this drug, an increased heart rate may not serve reliably as a sign of inadequate anesthesia. The MAC of desflurane decreases with increasing patient age.
The dose of desflurane should be adjusted accordingly. Table 61 provides mean relative potency based on age in ASA physical status I and II patients. 4 * N = number of cross over pairs (using up-and-down method of quantal response). When changing the depth of anesthesia, rapid increases in the end-tidal concentration of SUPRANE (desflurane) should be avoided and the end-tidal concentration increased in small increments of 1% or less.
It is not necessary to deliver concentrations of SUPRANE (desflurane) far in excess of the desired end-tidal concentration (“overpressurization” technique) due to the low blood and tissue solubilities of SUPRANE (desflurane) and the resulting rapid equilibrium of alveolar concentration with inspired and delivered concentrations; thus the transient and self-limiting increases in heart rate and blood pressure may be avoided.
SUPRANE (desflurane, USP) Page 8 of 54 During maintenance of anesthesia, increases in heart rate and blood pressure occurring after rapid incremental increases in end-tidal concentration of SUPRANE (desflurane) may not represent […]
The safety of SUPRANE (desflurane) has not been investigated in non-intubated pediatric patients younger than 2 years of age due to increased incidence of respiratory events observed in the 2 – 16 year age group. 2-10% SUPRANE (desflurane) in children with or without the concomitant use of nitrous oxide.
Geriatrics:
Geriatric patients require approximately 70% the adult dose in 100% oxygen and approximately 40% the adult dose in 60% nitrous oxide. SUPRANE (desflurane, USP) Page 7 of 54 During the maintenance of anesthesia with inflow rates of 2 L/min or more, the alveolar concentration of SUPRANE (desflurane) will usually be within 10% of the inspired concentration.
During the maintenance of anesthesia, increasing concentrations of SUPRANE (desflurane) produce dose-dependent decreases in blood pressure. Excessive decreases in blood pressure may be due to depth of anesthesia and in such instances may be corrected by decreasing the inspired concentration of SUPRANE (desflurane).
Concentrations of SUPRANE (desflurane) exceeding 1 MAC may increase heart rate. Thus with this drug, an increased heart rate may not serve reliably as a sign of inadequate anesthesia. The MAC of desflurane decreases with increasing patient age.
The dose of desflurane should be adjusted accordingly. Table 61 provides mean relative potency based on age in ASA physical status I and II patients. 4 * N = number of cross over pairs (using up-and-down method of quantal response). When changing the depth of anesthesia, rapid increases in the end-tidal concentration of SUPRANE (desflurane) should be avoided and the end-tidal concentration increased in small increments of 1% or less.
It is not necessary to deliver concentrations of SUPRANE (desflurane) far in excess of the desired end-tidal concentration (“overpressurization” technique) due to the low blood and tissue solubilities of SUPRANE (desflurane) and the resulting rapid equilibrium of alveolar concentration with inspired and delivered concentrations; thus the transient and self-limiting increases in heart rate and blood pressure may be avoided.
SUPRANE (desflurane, USP) Page 8 of 54 During maintenance of anesthesia, increases in heart rate and blood pressure occurring after rapid incremental increases in end-tidal concentration of SUPRANE (desflurane) may not represent inadequate anesthesia.
The changes due to sympathetic activation resolve in approximately 4 minutes. Increases in heart rate and blood pressure occurring before or in the absence of a rapid increase in SUPRANE (desflurane) concentration may be interpreted as light anesthesia.
0% end-tidal SUPRANE (desflurane) may attenuate these signs of light anesthesia, as may concomitant administration of analgesics. Should raised heart rate and blood pressure persist, then other causes should be sought. 4 Administration SUPRANE (desflurane) is administered by inhalation.
Deliver SUPRANE (desflurane) from a vaporizer specifically designed and designated for use with SUPRANE (desflurane). The administration of general anesthesia must be individualized based on the patient's response. SUPRANE (desflurane) should only be administered by persons trained in the administration of general anesthesia using a […]