propofoli

Propofol, sometimes referred to as propofoli in some contexts, is a short-acting intravenous sedative-hypnotic agent used for the induction and maintenance of anesthesia, as well as for procedural sedation and for sedation of intubated patients in intensive care. It is commonly administered as an oil-in-water emulsion and is valued for rapid onset and quick recovery. Propofol has little intrinsic analgesic effect; adjunct analgesia is typically provided with opioids or NSAIDs.

Mechanism and pharmacokinetics: Propofol acts primarily as a positive allosteric modulator of GABA-A receptors, enhancing inhibitory neurotransmission in the central nervous system. It rapidly crosses the blood-brain barrier, producing anesthesia within seconds after IV administration. Termination of effect is due to rapid redistribution to tissues and metabolism by the liver and other tissues. The context-sensitive half-time is short after brief infusions but lengthens with longer infusions.

Administration and safety: Induction doses in adults commonly range from 1 to 2.5 mg/kg, with maintenance infusions typically in the range of 25-75 mcg/kg/min for sedation and higher rates for anesthesia. Adverse effects include hypotension and respiratory depression, particularly during induction, as well as pain on injection. Rare but serious risks include propofol infusion syndrome with prolonged high-dose infusions, characterized by metabolic acidosis, rhabdomyolysis, and cardiac failure. Suitable monitoring is essential.

Formulation and notes: Propofol is supplied as a lipid emulsion containing soybean oil and egg lecithin; several formulations exist, including 1% and 2% solutions. It is a controlled substance in many jurisdictions due to potential for abuse. Brand names include Diprivan and others. Use should follow institution protocols and local regulations.