What is propofol


PropofolDrug groupsAnesthetics Injection Anesthetics Propofol is a short and fast acting, intravenous general anesthetic with numbing and sedative properties. It is used for general anesthesia and for sedation of ventilated adults during intensive care. The most common adverse effects include pain at the injection site, respiratory failure, low blood pressure, and a slow pulse. Nausea, vomiting, and headaches may occur upon waking up. Propofol is also misused for its calming, relaxing, slightly euphoric, and aphrodisiac effects. The abuse is potentially life-threatening.

synonymous: PropofolumPhEur, Diprivan®

Products

Propofol is commercially available as an emulsion for injection or infusion (Disoprivan®, generics). It has been approved in Switzerland since 1986.

Structure and properties

Propofol obtained by distillation (C.12H18O, Mr = 178.3 g / mol, 2,6-diisopropylphenol) is a colorless to light yellow, clear liquid that is sparingly soluble in water and miscible with hexane and methanol. The liquid in the commercially available ampoules is a milky-white emulsion (1-2%). It belongs to the group of phenols.

Effects

Propofol (ATC N01AX10) has anesthetic properties. It is short-acting, intravenous, with a rapid onset of action; calming, relaxing, euphoric, sexually disinhibiting and aphrodisiac.

Indications

For induction and maintenance of general anesthesia and for sedation of ventilated adults during intensive care. Propofol is also used off-label for headaches and migraines, but is not approved for this.

abuse

Propofol is also abused for its calming, relaxing, slightly euphoric, sexually disinhibiting, and aphrodisiac effects. It is popular, among other things, because of its rapid onset of action and its short duration of action. In addition, it is not a narcotic and therefore easier to obtain for abuse. It probably does not lead to physical, but to psychological dependence.

The abuse is potentially life-threatening, even in therapeutic concentrations. Particularly in the case of rapid injections, there may be a drop in blood pressure and respiratory arrest with insufficient oxygen supply. Another possible cause of death is pulmonary edema. The simultaneous misuse of other respiratory-depressant substances such as benzodiazepines and opioids is therefore probably problematic. Several deaths have been reported in the literature, including suicides and murders. Often the victims were health care professionals (especially anesthetists, nurses).

The death of Michael Jackson is also related to the use of propofol. According to media reports, Jackson's personal physician Dr. Conrad Murray Jackson administered propofol. Jackson has also taken numerous other drugs, including benzodiazepines.

Contraindications
  • Hypersensitivity
  • For sedation of children under 16 years of age in the intensive care unit

The complete precautionary measures can be found in the medicinal product information sheet.

Interactions

Fentanyl can increase propofol levels in the blood. Ciclosporin: leukoencephalopathy has been reported.

unwanted effects

Very often:

Often:

Overdose

Respiratory depression, cardiovascular depression, also with fatal outcomes.

see also

Anesthetics, phenols

literature
  • Medicinal product information (CH)
  • Reynolds J. (Ed.) Martindale. The Extra Pharmacopoeia. London: The Pharmaceutical Press, 1989
  • Kranioti E.F. et al. Lethal self administration of propofol (Diprivan). A case report and review of the literature. Forensic Sci Int, 2007, 167 (1), 56-8 Pubmed
  • Kirby R.R., Colaw J.M., Douglas M.M. Death from propofol: accident, suicide, or murder? Anesth Analg, 2009, 108 (4), 1182-4 Pubmed
  • Roussin A. et al. Pharmacological and clinical evidences on the potential for abuse and dependence of propofol: a review of the literature. Fundam Clin Pharmacol, 2007, 21 (5), 459-66 Pubmed
  • PhEur
  • TMZ.com
author

Conflicts of Interest: None / Independent. The author has no relationships with the manufacturers and is not involved in the sale of the products mentioned.

additional Information
Support PharmaWiki with a donation!

© PharmaWiki 2007-2021 - PharmaWiki provides independent and reliable information about medication and health.
This article was last changed on 11/21/2020.
Imprint and data protection declaration
Show products for this page