University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

475

Pages:

1
Author:

Mariam A. A.

Propofol Indications Procedural sedation Rapid onset, short duration, rapid recovery Moderate or deep sedation Can provide rapid, profound changes Can be used with or without other anesthetics Contraindications Known hypersensitivities to propofol or any ingredient in the formulation Known hypersensitivity to eggs, soybeans, or soy products Common Adverse Effects Bradycardia, arrhythmia, tachycardia, hypotension, apnea, respiratory acidosis, rash, pruritus, hyperlipidemia, burning/stinging pain at injection site Metabolism Hepatically mainly by CYP3A4 Hydroxylation of benzene ring to 4-hydroxypropofol via CYP2D6/2D9 The conjugation with sulfuric acid or glucuronic acid Mechanism of Action GABA-A receptor Subunit Alpha-1 Beta-2 Gamma-2 GABA-B receptor Presynaptic inhibition Signal transduction, excitation, or release Central nervous system Cerebral metabolic rate Cerebral blood flow ICP O2 consumption Properties & Other Info Lipid-rich Fospropofol is a pro-drug that is painful at injection site Works within 15-30 seconds after administration Improves psychomotor performance After administration, widely distributed, quickly binding to plasma proteins Hepatic conjugation changes it to inactive metabolites which are then eliminated by the kidneys Biphasic half-life Initial half-life: 40 minutes Terminal half-life: 4-7 hours Dosage General surgery ASA I or II: 2-2.5 mg/kg according to patient response until onset of induction Maintenance: 6-12 mg/kg/hr with inhaled 60-70% nitrous oxide May require 150-200 mcg/kg/hr ASA III or IV: 1.5-2.5 mg/kg for induction, 3-6 mg/kg/hr for maintenance Children (3-16 yrs): 2.5-3.5 mg/kg until onset Maintenance: 7.5-8 mg/kg/hr with inhaled nitrous oxide