ultane and Medihaler epi Interactions

Interactions between ultane(sevoflurane) and Medihaler epi (epinephrine)

epinephrine and sevoflurane (Major Drug-Drug)

GENERALLY AVOID: Rarely, the combination of epinephrine and some anesthetics has resulted in ventricular irritability, serious cardiac arrhythmias, or death. The halogenated anesthetics sensitize the heart to the arrhythmogenic effects of catecholamines.

MANAGEMENT: This combination should be avoided or used very cautiously. If a halogenated anesthetic and epinephrine must be used together, an epinephrine concentration of 1:100,000 or 1:200,000 is recommended. The adult dosage should not exceed 100 mcg of a 1:100,000 solution in any 10-minute period. The patient's hemodynamic status should be closely monitored. Lidocaine has a protective effect against the arrhythmogenic potential of epinephrine. Topical epinephrine appears to be relatively safe for use during anesthesia.