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Exploring the Impact of Propofol on Sympathetic Nervous System Activation
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Exploring the Impact of Propofol on Sympathetic Nervous System Activation

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Questions and Answers

Which drug induces a state of calm or sleep?

  • Sedative (correct)
  • Anxiolytic
  • Hypnotic
  • Propofol

    • What is the formulation of propofol?

  • Soybean oil and glycerol
  • Soybean oil and egg lecithin (correct)
  • Soybean oil and triglycerides
  • Soybean oil and purified egg phosphatide

    • Which drug is administered as a rapid IV injection and produces unconsciousness within about 30 seconds?

  • Propofol (correct)
  • Methohexital
  • Sedative-hypnotics
  • Thiopental

    • Which of the following statements about propofol's effect on urine is true?

    <p>Cloudy urine is not considered to be detrimental or indicative of adverse renal effects of propofol</p> Signup and view all the answers

    What effect does propofol have on intraocular pressure during laparoscopic surgery?

    <p>Propofol decreases intraocular pressure</p> Signup and view all the answers

    How does propofol affect coagulation and platelet function?

    <p>Propofol inhibits platelet aggregation induced by proinflammatory lipid mediators</p> Signup and view all the answers

    Which drug has replaced thiopental for induction of anesthesia in many clinical situations?

    <p>Propofol</p> Signup and view all the answers

    What is the typical dose of propofol for maintenance of anesthesia?

    <p>100 to 300 mg/kg/minute</p> Signup and view all the answers

    What is one of the advantages of propofol for conscious sedation techniques?

    <p>Minimal analgesic effects</p> Signup and view all the answers

    What is one of the therapeutic applications of propofol?

    <p>Treatment of chemotherapy-induced nausea and vomiting</p> Signup and view all the answers

    Which of the following is the major metabolic pathway for propofol?

    <p>Glucuronidation</p> Signup and view all the answers

    What is the elimination half-time of propofol?

    <p>0.5 to 1.5 hours</p> Signup and view all the answers

    Which population group exhibits a decreased rate of plasma clearance of propofol compared with younger adults?

    <p>Patients older than 60 years of age</p> Signup and view all the answers

    What is the induction dose of propofol in healthy adults?

    <p>1.5 to 2.5 mg/kg IV</p> Signup and view all the answers

    Which of the following statements about propofol is true?

    <p>Propofol can cause a decrease in heart rate and blood pressure.</p> Signup and view all the answers

    What is the recommended action to minimize the blood pressure reduction caused by propofol?

    <p>Ensure adequate hydration before rapid IV administration of propofol.</p> Signup and view all the answers

    How does propofol affect the lungs?

    <p>Propofol depresses ventilation and can cause apnea.</p> Signup and view all the answers

    What is a potential adverse effect of prolonged infusions of propofol?

    <p>Hepatocellular injury accompanied by lactic acidosis.</p> Signup and view all the answers

    Which of the following drugs is frequently added to propofol in attempts to prevent pain with IV injection?

    <p>Lidocaine</p> Signup and view all the answers

    Which of the following is NOT a difference between Diprivan and the generic formulation of propofol?

    <p>Lipid content</p> Signup and view all the answers

    Which of the following is a characteristic of Ampofol, a low-lipid emulsion of propofol?

    <p>Contains soybean oil and egg lecithin</p> Signup and view all the answers

    Which of the following is a characteristic of Aquavan, a prodrug of propofol?

    <p>Has a faster onset than propofol</p> Signup and view all the answers

    Which of the following is a potential mechanism of the antipruritic effect of propofol?

    <p>Segmental excitation within the spinal cord</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the cardiovascular system?

    <p>Inhibition of sympathetic vasoconstrictor nerve activity</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the central nervous system?

    <p>Modification of cortical somatosensory evoked potentials</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on bronchoconstriction?

    <p>Increased airway resistance in patients with a history of smoking</p> Signup and view all the answers

    Which of the following is NOT a potential effect of propofol on the renal system?

    <p>Adverse renal effects</p> Signup and view all the answers

    Which of the following is a potential risk associated with laparoscopic surgery in the presence of pre-existing ocular hypertension?

    <p>Increased intraocular pressure</p> Signup and view all the answers

    What effect does propofol have on coagulation and platelet function?

    <p>Inhibits platelet aggregation</p> Signup and view all the answers

    Which of the following best describes the formulation of propofol?

    <p>Propofol is an insoluble drug that requires lipid for emulsification.</p> Signup and view all the answers

    Which of the following is NOT an advantage of propofol for induction of anesthesia?

    <p>Reduced risk of bacterial growth</p> Signup and view all the answers

    What is the equivalent dose of propofol, administered as a rapid IV injection, compared to thiopental?

    <p>4 to 5 mg/kg IV</p> Signup and view all the answers

    Which drug has replaced thiopental for induction of anesthesia in many clinical situations in the United States?

    <p>Propofol</p> Signup and view all the answers

    What is the typical conscious sedation dose of propofol for IV sedation?

    <p>25 to 100 mg/kg/minute</p> Signup and view all the answers

    Which drug may be added to propofol for continuous IV sedation in selected patients?

    <p>Midazolam</p> Signup and view all the answers

    What is the typical dose of propofol for maintenance of anesthesia?

    <p>100 to 300 mg/kg/minute</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the liver?

    <p>Hepatotoxicity</p> Signup and view all the answers

    What is the primary mechanism of action of propofol in producing antipruritic effects?

    <p>Inhibition of spinal cord activity</p> Signup and view all the answers

    What is the main reason why propofol is preferred over thiopental for induction of anesthesia in many clinical situations?

    <p>Faster onset of action</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the respiratory system?

    <p>Enhanced mucociliary clearance</p> Signup and view all the answers

    Which of the following is a potential metabolite of propofol?

    <p>4-hydroxypropofol</p> Signup and view all the answers

    What is the context-sensitive half-time for propofol infusions lasting up to 8 hours?

    <p>Less than 40 minutes</p> Signup and view all the answers

    Which of the following is true about propofol's elimination in patients with cirrhosis of the liver?

    <p>No evidence of impaired elimination</p> Signup and view all the answers

    What is the induction dose of propofol in healthy adults?

    <p>1.5 to 2.5 mg/kg IV</p> Signup and view all the answers

    Which of the following is NOT a characteristic of propofol's mechanism of action?

    <p>Propofol causes drug-induced spinal cord depression.</p> Signup and view all the answers

    Which of the following is a characteristic of propofol's pharmacokinetics?

    <p>The liver is the main site of propofol metabolism.</p> Signup and view all the answers

    Which of the following is a characteristic of Diprivan?

    <p>Uses the preservative disodium edema te (0.005%) with sodium hydroxide to adjust the pH to 7 – 8.5.</p> Signup and view all the answers

    Which of the following is a characteristic of Ampofol?

    <p>Is equipotent to Diprivan but is associated with a higher incidence of pain on injection.</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the sympathetic nervous system?

    <p>Propofol decreases sympathetic nervous system activity.</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the oculocardiac reflex in pediatric strabismus surgery?

    <p>Propofol increases the incidence of the oculocardiac reflex.</p> Signup and view all the answers

    Which of the following is a potential effect of propofol on the ventilatory response to hypoxia?

    <p>Propofol decreases the ventilatory response to hypoxia.</p> Signup and view all the answers

    Which of the following is a potential effect of prolonged infusions of propofol on the liver?

    <p>Propofol may cause hepatocellular injury.</p> Signup and view all the answers

    Study Notes

    Overview of Propofol: a Versatile Sedative-Hypnotic Drug

    • Propofol is a sedative-hypnotic drug that induces a state of calm or sleep.
    • It is administered intravenously and produces rapid unconsciousness within about 30 seconds.
    • Propofol has a faster and more complete recovery compared to other drugs used for anesthesia induction.
    • The drug is insoluble and requires lipid for emulsification, with soybean oil and egg lecithin used as the oil phase and emulsifying agent, respectively.
    • Mixing propofol with other drugs is not recommended due to the risk of pulmonary embolism.
    • Commercial preparations of propofol, such as Diprivan and generic formulations, differ in preservatives used and pH levels.
    • Ampofol is a low-lipid emulsion of propofol that does not require preservatives but is associated with a higher incidence of pain on injection.
    • Non-lipid formulations of propofol, such as the prodrug Aquavan, provide an alternative to emulsion formulations.
    • Aquavan has slower onset, larger volume of distribution, and higher potency compared to propofol.
    • Cyclodextrins, currently in clinical trials, are ring sugar molecules that allow propofol to be presented in an injectable form.
    • Propofol modulates GABA A and glycine receptors, increasing the duration of GABA-activated chloride channel opening.
    • Propofol is rapidly metabolized and eliminated by the liver, with hepatic metabolism resulting in inactive metabolites excreted by the kidneys.

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    Description

    Quiz: Understanding the Impact of Propofol on Sympathetic Nervous System Activation during Desflurane Administration Test your knowledge on the effects of propofol on sympathetic nervous system activation during the administration of desflurane. Explore different reports and findings to gain a better understanding of the relationship between propofol, epinephrine concentration, and the cardiovascular response.

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