Propofol

A short-acting general anesthetic that is often used for outpatient, minor surgery.

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Propofol

Information about Propofol

Propofol is the mostly commonly used parenteral anesthetic agent in the United States, extensively used for minor and outpatient surgical procedures because of its rapid onset and reversal of action, and in intensive care units (ICUs) for maintenance of coma.

Liver safety of Propofol

Propofol has been associated with rare instances of idiosyncratic acute liver injury; in addition, prolonged high dose propofol therapy can cause the “Propofol infusion syndrome” which is marked by bradyarrhythmias, metabolic acidosis, rhabdomyolysis, hyperlipidemia and an enlarged or fatty liver.

Mechanism of action of Propofol

Propofol (proe' poe fol) is an intravenously administered anesthetic agent that is widely used for minor and outpatient surgical procedures. Chemically, propofol is 2,6-diisopropylphenol and its mechanism of action is similar to the barbiturates and benzodiazepines, binding to gamma amino butyric acid (GABA) receptors in the central nervous system. The binding is to a different site than the benzodiazepines and causes marked increases the neuroinhibitory actions of the GABA receptor resulting in increased chloride conduction and hyperpolarization of neurons. Propofol also lowers intracerebral pressure and reduces cerebral oxygen consumption. Importantly, propofol has the unique pharmacokinetic and pharmacodynamic features of rapid onset of action and rapid reversal with stopping which makes it a valuable agent for induction of anesthesia and for short-term procedures.

FDA approval information for Propofol

Propofol was approved for use in the United States in 1989 and it has become widely used for induction of general anesthesia, as an sole anesthetic agent for short, minor surgical and endoscopic procedures, and as a means of prolonged sedation in critically ill patients in intensive care units. Propofol is highly insoluble in water and is given in a lipid emulsion usually in a 1% solution of 10% soy bean oil.

Dosage and administration for Propofol

The typical induction dose of propofol is 1.5 to 2.5 mg/kg followed with small boluses or a constant low dose infusion for maintenance of anesthesia. Its commercial name is Diprivan. Propofol should be administered by a trained anesthesiologist or anesthetist with adequate availability of ventilatory and cardiac support. Deaths from propofol overdose have been reported, particularly with its abuse.

• Dailymed label info on Propofol
• FDA Propofol

Sedatives and Hypnotics

• Antihistamines
• Diphenhydramine
• Doxylamine
• Hydroxyzine

• Barbiturates
  • Amobarbital
  • Butabarbital
  • Phenobarbital
  • Secobarbital

• Benzodiazepines
  • Diazepam
  • Estazolam
  • Flurazepam
  • Quazepam
  • Temazepam
  • Triazolam

• Benzodiazepine Receptor Agonists
  • Eszopiclone
  • Zaleplon
  • Zolpidem

• Herbals
  • Chamomile (Matricaria recutita)
  • Hops (Humulus lupulus)
  • Lavender (Lavandula angustifolia)
  • Passionflower (Passiflora incarnata)
  • Valerian (Valeriana officinalis)

• Melatonin and its Analogues
  • Melatonin
  • Ramelteon
  • Tasimelteon

Miscellaneous Agents

• • Buspirone
  • Chloral hydrate
  • Doxepin
  • Meprobamate
  • Sodium Oxybate (Narcolepsy Agent)
  • Suvorexant