Propofol

Question 1

Adult induction dose:

Answer 1

2mg/kg IV

Question 2

Sedation dose:

Answer 2

25-100 mcg/kg/min

Question 3

TIVA dose:

Answer 3

100-300 mcg/kg/min

Question 4

Onset, E1/2 life, Protein binding, Context sensitive half time:

Answer 4

• Onset: 30 seconds unconscious
• E1/2L: 0.5-1.5hrs
• 98% protein bound
• Context half time: <40 min

Question 5

Other benefits of propofol:

Answer 5

• Bronchodilator
• Suppresses SNS response to laryngoscopy
• Anti nausea in low dose

Question 6

What is the duration of propofol?

Answer 6

1-8 min

Question 7

Propofol dose for antiemetic:

Answer 7

10-15mg IV then 10mcg/kg/min

Question 8

Propofol induction dose for peds:

Answer 8

2-4mg/kg
(larger central distribution volume and clearance rate d/t increase HR)

Question 9

What drug class is propofol?

Answer 9

GABA agonist

Question 10

What is a disadvantage of propofol?

Answer 10

• Supports bacterial growth
• Increase plasma TG with long infusions
• Pain on injection

Question 11

How is propofol metabolized/cleared in the body?

Answer 11

• Plasma→Lung first pass
• Tissue uptake (CYP450)

Question 12

Which CYP enzyme is responsible for individual variability of prop hydroxylation in the liver?

Answer 12

CYP2B6

Question 13

How is propofol dose adjusted for elderly?

Answer 13

Decrease dose by 25-50%

Question 14

Why is propofol a good drug for neuro cases?

Answer 14

• Decreases ICP
• No SSEP suppression
• Does not produce seizures

Question 15

What is the blackbox warning of propofol in peds?

Answer 15

Profound bradycardia
give glyco before

Question 16

What effects can happen from prolonged infusion of propofol?

Answer 16

• Hepatocellular injury
• Propofol infusion syndrome (lactic acidosis)
• Rhabdomyolysis

Question 17

What is propofol infusion syndrome?

Answer 17

Sudden onset of bradycardia that progresses to asystole and is resistance to treatment if not caught early