Pharmacology IV anesthetics Flashcards
(129 cards)
What is the pKa of Propofol?
11
What is the preservative in brand name Propofol?
Diprivan has the preservative disodium edetate
What is the preservative in generic Propofol?
sodium metabisulfite
1% solution in an emulsion of egg lecithin, soybean oil, and glycerol describes what drug?
Propofol
What is the MOA of propofol?
Direct GABA - A agonist which increases Cl conductance and leads to neuronal hyperpolarization
What is the induction dose for propofol?
What is the infusion range?
induction - 1.5-2.5 mg/kg IV
infusion - 25-200 mcg/kg/min
duration for propofol?
5-10 min.
How is Propofol cleared?
Liver (P450 enzymes) + extrahepatic metabolism
Where does extrahepatic clearance of propofol occur?
in the lungs mainly
True or false:
clearance of Propofol exceeds liver blood flow?
True
What does the chemical structure of Propofol look like?
6 sided
CH(CH3)2 side chains (2)
and an OH side chain
After an IV bolus of Propofol the brain concentration peaks at what time period?
after 1 min.
Awakening from Propofol is due to what?
redistribution out of the brain
Explain the cardio vascular effects of propofol in relation to: BP SVR venous tone myocardial contractility
decreased BP (due to decreased SNS tone and vasodilation)
decreased SVR
decreased venous tone (leads to decreased preload)
decreased myocardial contractility
Respiratory effects of Propofol?
Shifts the CO2 response curve down and to the right ( less sensitive to CO2).
Resp. depression and / or apnea inhibits hypoxic ventilatory drive.
What are the CNS effects of Propofol? CMRO2 CBF ICP IOP
decreased CMRO2
decreased CBF
decreased ICP
decreased IOP
Does Propofol have analgesic properties?
No
Does Propofol have anticonvulsant properties?
Yes
Can Propofol cause seizures?
There are a few reported cases of Propofol inducing seizures, but these are very rare exceptions.
It can cause myoclonus
If a Propofol infusion changes the urine color to green or cloudy, what does it mean?
green urine = phenol excretion
cloudy urine = increased uric acid excretion (does not suggest renal impairment or infection)
Explain Propofol infusion syndrome on the molecular level?
Propofol contains long chain triglycerides, and an increased LCT load impairs oxidative phosphorylation and fatty acid metabolism. This starves cells of oxygen, particularly in the cardiac and skeletal muscle.
What are they symptoms of Propofol infusion syndrome?
It presents with acute refractory bradycardia leading asystole and at least one of the following:
Metabolic acidosis ( base deficit > 10 mmol/L)
rhabdomyolysis
enlarged or fatty liver
renal failure
hyperlipidemia
lipemia (cloudy plasma or blood ) early sign
Are people who are allergic to eggs allergic to Propofol? Explain…
Most people with egg allergy are allergic to the albumin in the egg whites. Egg lecithin is derived from the yolk.
There is NO good evidence to support cross - sensitivity in egg allergic patients.
Is it safe to give people with egg allergies Propofol?
It is PROBABLY safe to administer to patients with egg allergies