Propofol (Diprivan®)

Front 1

Propofol - Class/physiochemical

Back 1

Sedative hypnotic

Alkylphenol --> insoluble and t/f formulated as emulsion c 10% soybean oil, 2.25% glycerol, 1.25% lecithin (component of egg) (good bacteria media, requires good sterile technique)

Use within 6 hours of drawing up

Front 2

Propofol - Pharmacodynamics

Back 2

MOA- Presumed potentiation of the chloride current
through GABAa receptors

CNS- acts primarily as hypnotic c no analgesia. Dec CBF
and ICP (expounded with MAP dec)

CVS- profound vasodilation (both venous and arterial) c
suprression of normal baroreflex (worse in elderly) -->
HYPOTENSION

Res- depressant often producing apnea (reduces tidal volume and rate). + reduces upper airway reflexes =]

Front 3

Propofol - Pharmacokinetics

Back 3

Onset - 40 seconds to 3 minutes

Lipophillic and preferentially partition to lipophilic tissues
like brain, spinal cord --> acounts for onset of action -->
termination primarily due to redistribution--> 8-10 min
wake up after single bolus

Rapidly metabolized in the liver to inactive water soluble
compounds excreted through the kidneys. Particpates in
aprox 30% extra hepatic metabolism (lungs)

Context sensitive half-time is brief even after a long
infusion and recover remains prompt

Front 4

Propofol - Indications

Back 4

IV induction of anesthesia

Conscious sedation - increasingly

Short duration general outside the operating room

Subanesthetic doses 10 to 20mg IV for postop N/V

Front 5

Propofol - Contraindications/precautions

Back 5

Hypotension, allergy to soy, egg, or lethicin

May need a smaller dose if the patient has taken narcotics or other CNS depressants

Front 6

Propofol - Side Effects

Back 6

Painful administration, bradycardia, arrhythmia, hypotension, rash

Unexpected tachy may mean possible metabolic acidosis from PROPOFOL INFUSION SYNDROME

Front 7

Propfol - Dosage

Back 7

Adults - 1 t0 2.5 mg / kg initial bolus over 10 seconds, repeat 25 – 50 mg as necessary to maintain desired level of sedation.

Child - 2.5 to 3.5 mg/ kg