Home Drug Guide Propofol

Drug Guide

Generic Name

Propofol

Brand Names Diprivan

Classification

Therapeutic: Anesthetic, Sedative

Pharmacological: GABA Receptor Modulator

FDA Approved Indications

  • Induction and maintenance of general anesthesia
  • Sedation for mechanically ventilated patients in ICU

Mechanism of Action

Propofol enhances the activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) at GABA-A receptors, leading to sedative, hypnotic, and amnesic effects.

Dosage and Administration

Adult: Induction: 2-2.5 mg/kg IV; maintenance infusion typically 25-75 mcg/kg/min

Pediatric: Dose depends on age and procedure, generally 2-3 mg/kg IV for induction and 25-75 mcg/kg/min infusion

Geriatric: Initial dose reduced by approximately 20-30% due to increased sensitivity

Renal Impairment: Use caution, adjust dose as needed, monitor closely

Hepatic Impairment: Use caution, no specific dose adjustment required but monitor for prolonged sedation

Pharmacokinetics

Absorption: Administered IV; does not involve absorption considerations

Distribution: Rapidly distributes into the brain and highly perfused tissues within minutes

Metabolism: Extensively metabolized in the liver via conjugation to inactive metabolites

Excretion: Metabolites excreted primarily in urine

Half Life: Approximately 2-4 hours

Contraindications

  • Known hypersensitivity to propofol or component substances

Precautions

  • Use with caution in patients with egg, soy, or peanut allergies, although these allergies are not absolute contraindications.
  • Increased risk of propofol infusion syndrome with prolonged high-dose infusions
  • Monitor for hypotension, respiratory depression, and cardiac depression

Adverse Reactions - Common

  • Hypotension (Common)
  • Respiratory depression (Common)
  • Pain on injection (Common)

Adverse Reactions - Serious

  • Propofol infusion syndrome (Rare but serious, includes metabolic acidosis, rhabdomyolysis, cardiac failure)
  • Anaphylaxis (Rare)

Drug-Drug Interactions

  • CNS depressants (additive sedative effects)
  • Vasopressors may have reduced effectiveness

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, blood pressure, and oxygen saturation

Diagnoses:

  • Impaired gas exchange
  • Risk for hypotension

Implementation: Ensure airway management equipment is available, titrate dose to clinical response

Evaluation: Assess level of sedation, blood pressure, respiratory rate, and oxygenation regularly

Patient/Family Teaching

  • Explain that sedation may cause dizziness or drowsiness, advise against operating heavy machinery
  • Inform about potential side effects like hypotension or respiratory depression
  • Report any allergic reactions, chest pain, or unusual symptoms

Special Considerations

Black Box Warnings:

  • Propofol infusion syndrome—potentially fatal condition characterized by metabolic acidosis, rhabdomyolysis, cardiac failure

Genetic Factors: No specific genetic considerations widely documented

Lab Test Interference: May alter serum triglyceride and cholesterol measurements in prolonged infusions

Overdose Management

Signs/Symptoms: Deep sedation, respiratory depression, hypotension, cardiac arrhythmias

Treatment: Supportive care, oxygen therapy, vasopressors if needed, mechanical ventilation if indicated; no specific antidote

Storage and Handling

Storage: Store at 20°C to 25°C (68°F to 77°F); protect from light

Stability: Stable up to the expiration date on the packaging

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.