Induction Meds: Propofol Flashcards
What is the most common concentration of a 1% solution?
- 10mg/mL
S39
What are the inactive ingredients in propofol? Why is one particularly important?
- 1.2% Lecithin (from egg yolks) can cause anaphylaxis with egg allergies.
- 2.25% glycerol
- 10% soybean oil
S39
What are the disadvantages of propofol’s inactive ingredient composition?
- ↑ bacterial growth
- ↑ plasma triglycerides with prolonged infusions
- Pain on injection
S39
Differentiate Ampofol and Aquavan.
Ampofol:
- low-lipid
- no preservative that burns on injection more often.
Aquavan:
- prodrug with less injection pain but causes dysesthesias. –
- Slower onset
- larger Vd
- high potency.
S40
What is the mechanism of action of propofol?
GABA-A receptor modulator that increases Cl⁻ conductance.
S41
How does propofol cause immobility through spinal cord-depression?
- Trick question. Immobility from propofol is not from drug-induced spinal cord depression.
What are the clearance characteristics of propofol?
The clearance of propofol is primarily through hepatic metabolism
with minor contributions from renal clearance and pulmonary elimination.
S 42
What metabolizes propofol?
CYP450 and UGT1A9
S42
What is the E ½ time of propofol?
- 30 - 90 minutes
S 42
What is the context-sensitive half-time of propofol?
Is this low or high?
- 40 minutes (for an 8 hours infusion)
- Low CS ½ time.
S42
Differentiate blood pressure and heart rate changes that occur with propofol vs thiopental.
- Propofol: ↓BP & ↓HR
- Thiopental: ↓BP & ↑HR
Does propofol cross the placenta?
What are the consequences of this?
- Yes but is rapidly cleared from neonatal circulation.
S45
Do cirrhosis and renal dysfunction have significant effects on propofol metabolism?
No
S45
What drug is the induction drug of choice?
Propofol
S46
What is theinduction dose of propofol in adults and children?
- Adults: 1.5-2.5 mg/kg IV
- Pediatrics:** higher doses** due to larger central volume and clearance rate.
What is the induction dose of propofol in the elderly?
1 mg/kg IV (25 - 50% lower than regular adult)
S47
What plasma Propofol levels would correlate with unconsciousness?
What about awakening?
- Unconscious: 2 - 6 μg/mL
- Awake: 1 - 1.5 μg/mL
S47
What is the conscious sedation dose of Propofol?
25 - 100 μg/kg/min