Propofol
A fast-acting IV anesthetic, given as a white lipid emulsion, used to start and maintain general anesthesia and for sedation.
Drug card
- How it works
- Enhancing inhibitory GABA-A receptor signaling in the brain
- Used for
- Inducing and maintaining general anesthesia
- Sedation for procedures (monitored anesthesia care)
- Sedation of ventilated adults in intensive care
- Known for
- Low blood pressure
- Apnea and breathing depression
- Pain or burning at the injection site
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does propofol work?
Propofol (2,6-diisopropylphenol) is thought to work as a positive modulator of GABA-A receptors, strengthening inhibitory signaling. It brings on unconsciousness within about 40 seconds, and rapid redistribution and clearance give quick waking after short use. It comes as an oil-in-water emulsion of soybean oil and egg lecithin, and it has no vagolytic action.
Like other intravenous anesthetics: Given IV, these drugs reach the brain fast and switch off consciousness, so they are used to start (induce) anesthesia and for sedation; propofol works within about 40 seconds. Their targets differ: propofol enhances inhibitory GABA-A receptor signaling, while ketamine blocks excitatory NMDA glutamate receptors. As with all general anesthetics, how they cause unconsciousness is not fully understood.
Uses
What is propofol used for?
- Inducing and maintaining general anesthesia
- Sedation for procedures (monitored anesthesia care)
- Sedation of ventilated adults in intensive care
Side effects
Side effects of propofol
- Low blood pressureKnown for
- Apnea and breathing depressionKnown forSerious
- Pain or burning at the injection siteKnown for
- Slow heart rate, rarely asystoleSerious
- ArrhythmiasSerious
- Propofol infusion syndrome (long, high-dose ICU use)Serious
- High triglycerides with long infusions
- AnaphylaxisSerious
- Seizures on waking in people with epilepsySerious
- Fever and sepsis from a contaminated emulsionSerious
- Rash and itching
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Contraindicated in people with anaphylaxis to egg or soy, which are in the emulsion.
- The emulsion can grow microbes: use strict asepsis, one vial for one patient, and discard within 12 hours of opening.
- Use lower doses and slower rates in older, frail or hemodynamically unstable patients.
- Long, high-dose ICU infusions risk propofol infusion syndrome: watch for acidosis, rising potassium and lipemia.
Good to know: Quick on and quick off: unconsciousness within about 40 seconds and prompt waking after short use. Unlike ketamine, it lowers blood pressure and often causes apnea at induction.
Remember it
A way to remember it
Propofol is the milk of amnesia; ketamine keeps the pressure up.
Propofol is a milky-white oil-in-water emulsion, made with soybean oil and egg lecithin, that switches off consciousness and lowers blood pressure. Ketamine, which blocks NMDA receptors, tends to raise blood pressure and heart rate instead.
Written for biofideX
Its class
Intravenous anesthetics
Other intravenous anesthetics with a card:
Easily mixed up with inhaled anesthetics, benzodiazepines and local anesthetics.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Anesthesia and muscle relaxants
Propofol is one of 8 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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