Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1. Top Drawer Meds > Propofol > Flashcards

Propofol Flashcards

1
Q

What is the brand/trade name for propofol?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BONUS

Which of the following is the chemical structure of propofol (Diprivan)?

A

Drug B is 2,6 diisopropylphenol - AKA Propofol

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pharmacologic category/class of propofol?

A
  • General Anesthetic - Hypnotic
  • Alkylphenol

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the mechanism of action of propofol?

A

Direct GABAA receptor agonist and potentiates actions of endogenous GABA → ⇑ Cl- conductance → neuronal hyperpolarization

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1
Nagelhout (7th ed.), p. 103

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the adult dosing of propofol for induction?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the pediatric dosing of propofol for induction?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the dosing range of propofol for continuous infusion (sedation, TIVA)?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the onset of action for propofol?

A
  • Immediate - 9-51 seconds (avg. 30 seconds)
  • “Textbook” answer is 30-60 seconds

Dose dependent and influenced by patient specific circulation time

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the duration of action for propofol?

A
  • 3-20 minutes — awakening is related to redistribution from brain

Duration may be dependent on dose, rate, and duration of administration - it is also influenced by patient specific circulation time/redistribution

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What organ(s) are responsible for propofol’s clearance (metabolism/elimination)?

A
  • Metabolism: Liver (P450), with extrahepatic metabolism in lungs likely
  • Elimination: Kidneys

Half-life: ~0.5-1.5 hours

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or False

Egg allergy is an absolute contraindication to propofol use

A

False

  • while propofol formulations include lecithin derived from egg yolks, there is no good evidence that it should be avoided in patients allergic to egg (or soy/peanut)

In fact, Europe does not even include this in manufacturing information!

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2

UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Because propofol is emulsified in soy and/or egg fats, bacterial growth is possible - spiked vials, and prepared syringes must be discarded within what time frame?

A
  • 6 hours if the drug has been removed from the vial
  • 12 hours if the drug remains in the vial (after rubber stopper has been punctured - i.e. during infusion)

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1
Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2
UpToDate - Propofol: Drug Information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cardiovascular effects of propofol include:

A
  • Decreased SVR & BP
    ↓ SNS tone, vasodilation
  • Decreased venous tone → decreased preload
  • Decreased CO
    myocardial depression/↓ myocardial contractility

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the respiratory effects of propofol?

A
  • Dose dependent depression of ventilation
    (shifting of the CO2 response curve)
  • Apnea following initial administration/induction
  • Inhibits hypoxic ventilatory drive
  • Bronchodilation

Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

Nagelhout (7th ed.), p. 104

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What effect does propofol have on the CNS (e.g. CMRO2, cerebral blood flow, ICP)

A
  • ↓ CMRO2, ↓ CBF (maintains coupling)
  • ↓ ICP

Some say myoclonus is possible, but much less common than etomidate

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BONUS

Propofol infusions can change the color of the urine

  • green urine = _________ excretion
  • _______ urine = increased uric acid excretion (does not suggest renal impairment or infection)
A
  • phenol
  • cloudy

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 1. Propofol: Part 1

17
Q

The following preservatives may be used in different generic formulations of propofol - which patient populations should they warrant precaution in?

  1. Benzyl alcohol
  2. Sodium metabisulfite
A
  1. Avoid in infants (neurotoxicity)
  2. Use with caution in patients with allergies and asthma (may cause bronchospasm)

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2

Benzyl Alcohol

Nagelhout (7th ed.), p. 102 - Table 9.1

18
Q

Propofol may cause pain or burning on injection - how can this be eliminated or minimized?

A
  • Use of a larger and more proximal vein
  • Giving an opioid or lidocaine prior to administration

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2

19
Q

Propofol has antipruritic effects and can reduce itching caused by spinal opioids and cholestasis - what is the appropriate dose for this indication?

A
  • 10 mg IV

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2

20
Q

Propofol has antiemetic effects and can be used to treat PONV - what is the appropriate dose for this indication?

A
  • 10-20 mg IV
  • Infusion of 10 mcg/kg/min can also be used

Apex Unit 4: Pharmacology 1; Intravenous Anesthetics; Lesson 2. Propofol: Part 2

21
Q

What is the concentration (mg/mL) of propofol vials?

A
  • 10 mg/mL

Vials are often 10 mL, 20 mL, 50 mL, or 100 mL

UpToDate - Propofol: Drug Information

1. Top Drawer Meds (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions