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Drugs > Propofol > Flashcards

Propofol Flashcards

1
Q

What medium is propofol presented in?

A

An emulsion containing 1% propofol in a lipid medium

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2
Q

What is the induction dose for propofol?

A

1 - 2.5 mg/kg (adults)

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3
Q

What is the onset/offset of propofol?

A

30 seconds on

3-7 mins off

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4
Q

How is propofol metabolised?

A

2 pathways:

  • conjugated in liver to glucuronide
  • hydroxylated to quinol, which is subsequently glucuronidated
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5
Q

What chemical class is propofol?

A

Phenol derivative

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6
Q

What physicochemical properties does propofol have?

A

Extremely lipid soluble
pKa 11 - exists almost completely unionized
98% bound to plasma proteins
Exists as lipid emulsion of propofol and emulsifying agent (egg phosphatide and glycerol)
Contains 1% propofol (10 mg/ml)

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7
Q

What physicochemical property must induction agents have in order to reach the brain?

A

Lipid soluble to cross the BBB

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8
Q

What is the MOA of propofol?

A

Thought to be:

  • reduced opening times of sodium channels in neuronal membranes of CNS
  • potentiates glycine and GABA (inhibitory neurotransmitters)
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9
Q

What are the RS effects of propofol?

A 
Respiratory depression
Tachypnoea and decreased tidal volume
Decreased response to hypercapnea and hypoxia
Bronchodilation
Decreased laryngeal reflex
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10
Q

What are the CNS effects of propofol?

A

Smooth rapid induction
Decreased ICP
Decreased CPP
Myoclonic movements

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11
Q

What are the CVS effects of propofol?

A

Hypotension
Decreases SV by 15-25%
Vasodilation secondary to NO production
Bradycardia/asystole

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12
Q

What are the SEs of propofol?

A

Pain on injection
Epileptiform movements
Unlicensed in <16yrs (due to LT use in ICU - fat overload)
Green hair and urine (quinol metabolites)
Increased energy needed for DCCV

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13
Q

What are the chemical properties of propofol?

A 
Poorly H2O soluble
Weak organic acid
pKa = 11 (almost totally un-ionised at pH 7.4)
pH 7
Scavenges free radicals
Physical incompatibility with atracurium
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14
Q

What is the metabolism and excretion of propofol?

A

Hepatic metabolism - mostly conjugated to inactive glucuronide
Renal excretion
Renal/liver dysfunction doesn’t alter metabolism
No active metabolites
Clearance > hepatic blood flow = extra hepatic metabolism

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15
Q

What are the uses of propofol?

A

Induction/maintenance anaesthesia
Refractory N&V
Status epilepticus
Sedation

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16
Q

What is the absorption/distribution of propofol?

A

98% protein bound
Volume of distribution = 4L/kg
Rapid distribution to tissues
Rapid elimination (T1/2 1-5hrs)

17
Q

What is propofol?

A

2,6 diisopropylphenol

1-2% white lipid water emulsion in soya bean oil and purified egg phosphatide

Drugs (30 decks)

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