Induction Agent - Propofol Flashcards
What is the typical induction dose range of Propofol for adults?
A. 1-1.5 mg/kg
B. 2-2.5 mg/kg
C. 2.5-3.5 mg/kg
D. 3-4 mg/kg
B. 2-2.5 mg/kg
For pediatric patients, what is the recommended intravenous induction dose range of Propofol?
A. 1-2 mg/kg
B. 2-2.5 mg/kg
C. 2.5-3.5 mg/kg
D. 3.5-4.5 mg/kg
C. 2.5-3.5 mg/kg
What is the range of Propofol infusion doses for** sedation** in micrograms per kilogram per minute (mcg/kg/min)?
A. 10-50 mcg/kg/min
B. 15-60 mcg/kg/min
C. 25-75 mcg/kg/min
D. 50-100 mcg/kg/min
C. 25-75 mcg/kg/min
Tx Wes Reference:
25 - 100 µ/kg/min sedation
100 - 300 µ/kg/min TIVA
What is the infusion dose range for Propofol when used for general anesthesia (GA)?
A. 25-50 mcg/kg/min
B. 50-100 mcg/kg/min
C. 100-200 mcg/kg/min
D. 200-300 mcg/kg/min
C. 100-200 mcg/kg/min
Tx Wes Reference:
5 - 100 µ/kg/min sedation
100 - 300 µ/kg/min TIVA
What is the concentration of Propofol typically provided in its injectable form?
A. 1 mg/mL
B. 5 mg/mL
C. 10 mg/mL
D. 20 mg/mL
10 mg/mL
What is the primary mechanism of action (MOA) of Propofol?
A. NMDA receptor antagonist
B. GABAA receptor agonist
C. Dopamine receptor antagonist
D. Serotonin reuptake inhibitor
B. GABAA receptor agonist
How does Propofol’s activation of the GABAA receptor affect postsynaptic neurons?
A. Increases calcium conductance
B. Increases sodium conductance
C. Increases chloride conductance
D. Increases potassium conductance
C. Increases chloride conductance
What is the onset time of Propofol when administered intravenously?
A. 10 seconds
B. 30 seconds
C. 1-2 minutes
D. 3-5 minutes
B. 30 seconds
Tx Wes Reference:
30-60 sec
What is the typical duration of action for Propofol?
A. 1-3 minutes
B. 5-10 minutes
C. 15-20 minutes
D. 30 minutes
B. 5-10 minutes
Tx Wes Reference:
1-8 min
What causes Propofol’s rapid onset and short duration of action?
A. Rapid metabolism in the liver
B. Uptake into the brain and redistribution to fat/muscle
C. Renal excretion
D. Slow absorption into the bloodstream
B. Uptake into the brain and redistribution to fat/muscle
not d/t metabolism!
What is the effect of Propofol on chloride conductance in postsynaptic neurons?
A. It decreases chloride conductance
B. It increases chloride conductance
C. It has no effect on chloride conductance
D. It blocks chloride channels
B. It increases chloride conductance
What is the typical elimination half-life of Propofol?
A. 0.1-0.5 hours
B. 0.5-1.5 hours
C. 1-3 hours
D. 3-5 hours
B. 0.5-1.5 hours
What is the context-sensitive half-time of Propofol?
A. About 5 minutes for every 1 hour infused
B. About 10 minutes for every 1 hour infused
C. About 15 minutes for every 2 hours infused
D. About 30 minutes for every 2 hours infused
C. About 15 minutes for every 2 hours infused
Castillo:
Elimination half-time: 0.5 to 1.5 hours
Context-sensitive half-time: 40 minutes (8-hour infusions)
Which factor is the primary mechanism for Propofol’s clearance from plasma?
A. Renal excretion
B. Hepatic metabolism
C. Pulmonary uptake
D. Plasma protein binding
C. Pulmonary uptake
Clearance from plasma (pulmonary uptake) > hepatic blood flow (CYP)
How is Propofol eliminated from the body?
A. As active compounds via the liver
B. As inactive water-soluble compounds via the kidneys
C. Through unchanged excretion in the bile
D. Through biotransformation in the plasma
B. As inactive water-soluble compounds via the kidneys
What impact does renal or liver disease have on Propofol elimination?
A. It significantly prolongs the elimination half-life
B. It does not alter the elimination of Propofol
C. It enhances the clearance of Propofol
D. It changes Propofol to active metabolites
B. It does not alter the elimination of Propofol
What percentage of Propofol is bound to plasma proteins?
A. 85%
B. 90%
C. 98%
D. 100%
C. 98%
What is the primary action of Propofol when administered intravenously?
A. Analgesic
B. Anticonvulsant
C. Lipophilic Sedative-hypnotic and general anesthetic
D. Muscle relaxant
C. Lipophilic Sedative-hypnotic and general anesthetic
Which of the following is a precaution associated with Propofol administration?
A. Increased blood pressure
B. Enhanced myocardial contractility
C. Pronounced decrease in systemic blood pressure and profound bradycardia
D. Increased renal function
C. Pronounced decrease in systemic blood pressure and profound bradycardia
What is Propofol infusion syndrome and what does it lead to?
A. Inhibition of long-chain fatty acids from cellular entry, and having oxidative phosphorylation (aerobic resp) occur leading to metabolic acidosis, rhabdomyolysis, arrhythmias, and lipemia
B. Accumulation of short-chain fatty acids causing hyperglycemia
C. Enhancement of oxidative phosphorylation, leading to respiratory alkalosis
D. Increase in cellular fatty acid transport, leading to increased metabolic rate
A. Inhibition of long-chain fatty acids from cellular entry, and having oxidative phosphorylation (aerobic resp) occur leading to metabolic acidosis, rhabdomyolysis, arrhythmias, and lipemia
What is a common issue associated with Propofol that causes pain on injection?
A. High pH
B. Low lipid solubility
C. Being an alkylphenol
D. High protein binding
C. Being an alkylphenol
What is the main cause of allergic reactions to Propofol, and how does it relate to egg yolk lecithin allergies?
A. Allergic reactions are usually due to egg yolk lecithin, and it is unsafe for patients with such allergies
B. Allergic reactions are often due to sulfide preservatives, not egg yolk lecithin
C. Egg yolk lecithin is a common allergen, making Propofol unsafe for patients with these allergies
D. Allergic reactions are due to high protein content, unrelated to preservatives
B. Allergic reactions are often due to sulfide preservatives, not egg yolk lecithin
How should Propofol be handled to prevent bacterial growth?
A. Store at room temperature and use within 12 hours
B. Discard the syringe after 6 hours
C. Refrigerate and use within 24 hours
D. Use only sterile equipment and discard after 24 hours
B. Discard the syringe after 6 hours
What is the Black Box Warning associated with Propofol?
A. Risk of liver damage in patients with pre-existing conditions
B. Severe bradycardia in children and elderly patients
C. Risk of severe respiratory depression in patients with chronic obstructive pulmonary disease (COPD)
D. High risk of drug interactions with antihypertensives
B. Severe bradycardia in children and elderly patients
Which of the following is decreased by Propofol administration?
A. Cerebral blood flow (CBF)
B. Intracranial pressure (ICP)
C. Cerebral metabolic rate for oxygen (CMRO2)
D. IOP
E. CPP
F. All of the above
F. All of the above
Which of the following EEG changes can be produced by Propofol?
A. Decreased burst suppression
B. Increased frequency of brain waves
C. Burst suppression
D. Increased amplitude of brain waves
C. Burst suppression
How does Propofol affect the seizure threshold?
A. Lowers the seizure threshold
B. Has no effect on seizure threshold
C. Raises the seizure threshold
D. Causes seizures
C. Raises the seizure threshold
Which of the following cardiovascular effects is commonly associated with Propofol administration?
A. Increased blood pressure and tachycardia
B. Pronounced decrease in blood pressure, vasodilation, bradycardia, and asystole
C. Minimal effect on blood pressure and heart rate
D. Increased systemic vascular resistance and hypertension
B. Pronounced decrease in blood pressure, vasodilation, bradycardia, and asystole
What is a significant pulmonary side effect of Propofol?
A. Enhanced CO2 response
B. Increased respiratory rate
C. Potent respiratory depression, including apnea and decreased CO2 response
D. Minimal effect on respiratory function
C. Potent respiratory depression, including apnea and decreased CO2 response
What is the effect of Propofol on bronchial airways?
A. Causes bronchoconstriction
B. Has no effect on bronchial airways
C. Causes bronchodilation
D. Increases bronchial secretions
C. Causes bronchodilation
How does Propofol affect platelet aggregation?
A. Enhances platelet aggregation
B. Has no effect on platelet aggregation
C. Inhibits platelet aggregation
D. Causes platelet clumping
C. Inhibits platelet aggregation
Which of the following effects of Propofol contributes to its use as an antiemetic?
A. Its ability to increase gastric motility
B. Its anti-pruritic effect
C. Its central nervous system effects, reducing nausea and vomiting
D. Its bronchodilator properties
C. Its central nervous system effects, reducing nausea and vomiting
Propofol, while not directly antidopaminergic, appears to exert its antiemetic effects through the stimulation of GABA receptors and a reduction in the secretion of serotonin
