Propofol

CLINICAL USE

Induction and maintenance of general anaesthesiaSedation of ventilated patients for up to 3 days

DOSE IN NORMAL RENAL FUNCTION

Induction: 1.5–2.5 mg/kg at a rate of 20–40 mg every 10 secondsMaintenance: 25–50 mg repeated according to response or 4–12 mg/kg/hourSedation: 0.3–4 mg/kg/hour Sedation for surgical and diagnostic procedures: 0.5–1 mg/kg over 1–5 minutes then maintenance: 1.5–4.5 mg/kg/hour or

10 to 20 : mg/kg

PHARMACOKINETICS

Molecular weight :178.3

%Protein binding :>95

%Excreted unchanged in urine : <0.3

Volume of distribution (L/kg) :8–19

half-life – normal/ESRD (hrs) :3–12/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in normal renal function

HD :Unlikely to be dialysed. Dose as in normal renal function

HDF/high flux :Unlikely to be dialysed. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAdrenergic-neurone blockers: enhanced hypotensive effectAntihypertensives: enhanced hypotensive effect

Antidepressants: avoid MAOIs for 2 weeks before surgery; increased risk of arrhythmias and hypotension with tricyclics

Antipsychotics: enhanced hypotensive effectMuscle relaxants: increased risk of myocardial depression and bradycardia with suxamethonium

ADMINISTRATION

Reconstition

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Route

Rate of Administration

See local protocols

Comments

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See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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