Propofol Flashcards
Propofol Mechanism of Action
Delays dissociation of GABA from receptors - increasing GABA activated opening of chloride ion channels, also acts as a sodium channel blockers. Hyperpolarization of cell membranes.
Propofol Protein Binding
95-99%
Propofol Elimination half-life
30-60 minutes
Propofol Metabolization
Glucoronidation in the liver, 30% may occur in lungs (clearance exceeds hepatic blood flow)
Propofol Excretion
Renal
Propofol Redistribution
Into brain rapidly then goes out to other organs, patient wakes up in about 5-8 minjuts
Propofol CV Effects
Decrease: SBP, MAP, SVR (profound arterial & venous vasodilations decreases preload & afterload, baroreceptor response will not kick in). HR stays the same
Propofol RR Effects
RR depressed dose dependent, apnea after bolus. Reduces airway reflex but not does not cause nonreactive airway. Good bronchodilator
Propofol CNS effects
Decrease: CBF (cerebral blood flow), ICP, CMRO2 (cerebral metabolic rate for oxygen), IOP (intraocular pressure). May decrease CPP*
Propofol Induction dose adults
1.5 to 2.5 mg/kg - decrease for elderly, CV disease
Propofol Induction dose children
2.5-3.5 mg/kg
Propofol Continuous infusion for sedation
25-100 mcg/kg/min
Propofol Continuous infusion for anesthesia (TIVA)
100-300 mcg/kg/min
Propofol Things to be aware of
Unconsciousness in 30-60 seconds, minimal if any hangover effect, decreased PONV & PODV, hypnotic but not analgesic, allergic reactions with eggs, bacteria formation - must use in 6 hours
Propofol Infusion Syndrome
Acute refractory bradycardia in kids, RBBB early sign, may lead to asystole if one or more occurs: metabolic acidosis, rhabdomyolisis, hyperlipidemia, enlarged/fatty liver. Associated with propofol infusion >4 mg/kg for >48 hours
