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Propofol Brand Names- Diprivan | Fresenius Propoven
What is Propofol
Propofol is an intravenous general anesthetic and sedative indicated for general anesthesia induction and maintenance, monitored anesthesia care (MAC) sedation, combined sedation and regional anesthesia, and intensive care unit (ICU) sedation of mechanically ventilated patients.
Propofol has many characteristics of the ideal anesthetic agent, including rapid onset, predictable duration, and quick recovery.
Propofol also has significant antiemetic activity and reduces the risk of nausea and vomiting. Comparative clinical studies have shown that the hemodynamic effects, including hypotension and decreased cardiac output, of propofol during anesthesia induction are generally more pronounced than with other intravenous induction agents.
Induction of anesthesia with propofol is also frequently associated with apnea in both adults and pediatric patients.
Since propofol is formulated in an oil-in-water emulsion, elevations in serum triglycerides may occur when propofol is administered for extended periods; monitoring for increases in serum triglycerides or serum turbidity is necessary in patients at risk for hyperlipidemia.
Use of propofol infusions for ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as propofol-related infusion syndrome (PRIS), that have resulted in death.
A major risk factor for the development of these events is prolonged, high-dose infusions of propofol (more than 5 mg/kg/hour for more than 48 hours); however, the syndrome has also been reported after large-dose, short-term infusions during surgical anesthesia.
Guidelines recommend nonbenzodiazepine sedatives, such as propofol, over benzodiazepines for sedation in critically ill, mechanically ventilated adult patients.
There is a potential for overdose with Fresenius Propoven 2%, which the FDA has permitted for emergency use under an Emergency Use Authorization (EUA) to maintain sedation by continuous infusion in patients 17 years and older who require mechanical ventilation in an ICU.
Fresenius Propoven 2% (propofol 20 mg/mL) is double the concentration of FDA-approved propofol 1% (propofol 10 mg/mL). Exercise caution and implement steps to ensure dosing calculations, infusion rates, and infusion pump settings are accurate.
Indications
- general anesthesia induction
- general anesthesia maintenance
- monitored anesthesia care sedation
- procedural sedation
- sedation induction
- sedation maintenance
For general anesthesia induction
Side Effects
- abnormal dreams
- agitation
- amblyopia
- anaphylactoid reactions
- angioedema
- anxiety
- apnea
- asthenia
- atrial fibrillation
- AV block
- bleeding
- bradycardia
- bronchospasm
- bundle-branch block
- cardiac arrest
- chest pain (unspecified)
- chills
- confusion
- conjunctival hyperemia
- cough
- dehydration
- delirium
- depression
- diaphoresis
- diarrhea
- diplopia
- drowsiness
- dysgeusia
- dyspnea
- dystonic reaction
- edema
- emotional lability
- erythema
- euphoria
- fatigue
- fever
- flushing
- hallucinations
- headache
- heart failure
- hiccups
- hyperglycemia
- hyperkalemia
- hypersalivation
- hypertension
- hypertonia
- hypertriglyceridemia
- hyperventilation
- hypomagnesemia
- hypotension
- hypotonia
- hypoventilation
- hypoxia
- ileus
- increased intracranial pressure
- infection
- injection site reaction
- insomnia
- laryngospasm
- leukocytosis
- metabolic acidosis
- myalgia
- myocardial infarction
- myoclonia
- nausea
- nystagmus
- ocular pain
- oliguria
- pancreatitis
- paresthesias
- pharyngitis
- phlebitis
- premature atrial contractions (PACs)
- premature ventricular contractions (PVCs)
- propofol-related infusion syndrome
- pruritus
- pulmonary edema
- rash
- renal failure (unspecified)
- respiratory depression
- seizures
- shivering
- sinus tachycardia
- sneezing
- supraventricular tachycardia (SVT)
- syncope
- tachypnea
- thrombosis
- tinnitus
- tissue necrosis
- tremor
- urinary retention
- urine discoloration
- urticaria
- ventricular fibrillation
- ventricular tachycardia
- vomiting
- weakness
- wheezing
- xerostomia
- zinc deficiency
Monitoring Parameters
- blood pressure
- heart rate
- pulse oximetry
- serum triglycerides
Contraindications
- abrupt discontinuation
- asthma
- brain tumor
- breast-feeding
- burns
- cardiac disease
- cerebrovascular disease
- children
- corticosteroid therapy
- diarrhea
- driving or operating machinery
- egg hypersensitivity
- geriatric
- head trauma
- hyperlipidemia
- hyperlipoproteinemia
- hypovolemia
- in utero exposure
- increased intracranial pressure
- infants
- labor
- neonates
- obstetric delivery
- pancreatitis
- peanut hypersensitivity
- potential for overdose or poisoning
- pregnancy
- premature neonates
- renal failure
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- seizure disorder
- sepsis
- soya lecithin hypersensitivity
- stroke
- sulfite hypersensitivity
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Acrivastine; Pseudoephedrine
- Aliskiren
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Aliskiren; Valsartan
- Ambrisentan
- Amikacin
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Amoxapine
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Apomorphine
- Apraclonidine
- Articaine; Epinephrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine
- Azelastine; Fluticasone
- Bacitracin
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Benzonatate
- Benzphetamine
- Beta-adrenergic blockers
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buspirone
- Butabarbital
- Butorphanol
- Calcium-channel blockers
- Cannabidiol
- Capreomycin
- Capsaicin; Metaxalone
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carisoprodol
- Cenobamate
- Central-acting adrenergic agents
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlorcyclizine
- Chloroprocaine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorzoxazone
- Cholinesterase inhibitors
- Clemastine
- Clobazam
- Clomipramine
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Cyclizine
- Cyproheptadine
- Dantrolene
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Desipramine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmedetomidine
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dichlorphenamide
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dopamine
- Doxazosin
- Doxepin
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Droperidol
- Dyphylline
- Dyphylline; Guaifenesin
- Enflurane
- Ephedrine
- Epinephrine
- Eplerenone
- Epoprostenol
- Esketamine
- Eszopiclone
- Ethanol
- Etomidate
- Fenfluramine
- Fentanyl
- Gabapentin
- Gentamicin
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Haloperidol
- Halothane
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxyzine
- Ibuprofen; Oxycodone
- Iloprost
- Imipramine
- Ionic Contrast Media
- Isoproterenol
- Kanamycin
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levodopa
- Levorphanol
- Lidocaine
- Lidocaine; Prilocaine
- Lisdexamfetamine
- Lofexidine
- Loop diuretics
- Lopinavir; Ritonavir
- Loxapine
- Lumateperone
- Magnesium Salts
- Maprotiline
- Mecamylamine
- Meclizine
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Meprobamate
- Metaxalone
- Methadone
- Methamphetamine
- Methohexital
- Midodrine
- Minocycline
- Mirtazapine
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nabilone
- Nalbuphine
- Nesiritide, BNP
- Norepinephrine
- Nortriptyline
- Ombitasvir; Paritaprevir; Ritonavir
- Orphenadrine
- Oxycodone
- Oxymorphone
- Oxytocin
- Papaverine
- Pentobarbital
- Perphenazine; Amitriptyline
- Phenobarbital
- Phenoxybenzamine
- Phenylephrine
- Phenylephrine; Promethazine
- Polymyxin B
- Polymyxins
- Potassium-sparing diuretics
- Prazosin
- Pregabalin
- Prilocaine
- Prilocaine; Epinephrine
- Primidone
- Procaine
- Procarbazine
- Protriptyline
- Rasagiline
- Reserpine
- Ritodrine
- Ritonavir
- Secobarbital
- Sedating H1-blockers
- Sodium Oxybate
- Sotalol
- St. John’s Wort, Hypericum perforatum
- Streptomycin
- Suvorexant
- Tapentadol
- Terazosin
- Tetracaine
- Theophylline, Aminophylline
- Thiazide diuretics
- Thiopental
- Thiothixene
- Tobramycin
- Tramadol
- Treprostinil
- Tricyclic antidepressants
- Trimipramine
- Triprolidine
- Trovafloxacin, Alatrofloxacin
- Valproic Acid, Divalproex Sodium
- Vancomycin
- Vasodilators
- Warfarin
- Zaleplon
- Zolpidem
