Non- Barbiturates Flashcards
What are non-bariturate induction agents? (3)
propofol
etomidate
ketamine
What is the European substitute for propofol?
What is the difference between the 2 drugs?
Propiven
Propiven has no preservatives.
What ingredient in propofol:
promotes bacteria growth?
causes it to burn?
acts as the preservative?
10% soybean oil
- 25% glycerol
- 005% disodium edatate
Purified egg phosphatide is similar to what part of the egg?
yellow
What is the shelf life of disodium edatate? EDTA?
6 hours
12 hours
Propofol metabolism % distribution: (2)
70% hepatic metabolism
30% lung metabolism
Patients with cirrhosis of the liver will still clear propofol rapidly.
What is a contraindication to propofol?
beta blockers cause further hypotension since it can cause vasodilation
Does kidney dysfunction affect pharmacokinetics?
Does age?
Does it reach the placenta?
no
yes, give lower dose
yes but gets metabolized–discard milk 24 hours after getting propofol
What is propofol’s effect on CMRO2?
On cerebral flow?
On ICP?
On CPP?
decreases all
To maintain perfusion pressure, norepi will be given to constrict vessels
What is propofol’s mechanism of action?
GABAa receptors, opening the Cl ion channels that hyperpolarize the cell and functional inhibition of the postsynaptic membrane
Propofol:
Dose?
Onset time?
Peak effect?
Duration?
1-2.5 mg/kg
30 seconds
Peak effect : 1.5 to 2 minutes
Duration : 5-10 minutes (dose dependent)
How is propofol metabolized and eliminated?
Clearance from plasma exceeds hepatic blood flow and metabolism by CYP P450.
Eliminated by kidneys 0.5-1.5 hours
Despite rapid clearance of propofol by metabolism, there is no evidence of impaired elimination in patients with cirrhosis of the liver. True or false?
true
Renal dysfunction does not influence the clearance of propofol despite the observation that nearly 3/4’s of propofol metabolites are eliminated in urine in the first 24 hours. True or false?
true
Compared with thiopental, propofol decreases the prevalence of wheezing after induction of anesthesia and tracheal intubation in healthy and asthmatic patients. True or false?
true
How does propofol affect CMRO2,
cerebral flow, and intracranial pressure?
decreases all
At equal levels of sedation, propofol produces the same degree of memory impairment as midazolam whereas thiopental has mild memory effects. True or false?
true
Propofol produces decreases in systemic blood pressure that are greater than those evoked by comparable doses of thiopental. True or false?
true
Pulmonary effects of propofol administration: (3)
decreased respirations, tidal volume, and
increased bronchodilation
Does propofol keep the hypoxic pulmonary vasoconstriction intact?
yes
There are hepatic/renal effects of propofol.True or false?
false
The urine may turn green after prolonged use of drug.
Side effects of propofol:(4)
allergic reaction
anti-convulsant
bacterial growth
PAIN on injection
What is the IV sedation of propofol?
What is TIVA dose?
25-100 mcg/kg/min
100-200 mcg/kg/min
Use propofol for only __ days because patients can develop hyperlipidemia. This is especially important for ICU pt care.
3
