Propofol

- 1%: 100 mg /10 ml, 200 mg/20 ml, 500 mg/50 ml and 1000 mg/100 ml vials (IV).

- 2%: 1000 mg/50 ml and 2000 mg/100 ml vials (IV).

Executive Summary

(August 31, 2023)

Propofol is a hypnotic agent that enhances the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the brain through NMDA and GABA-A receptors, resulting in sedation and unconsciousness (1). It is the third most commonly used induction agent in the ED, following etomidate and ketamine (25). 


Cautions summary


Adult dose for rapid sequence intubation (RSI) (25)

1.5 mg/kg IV bolus.

Adult dose

Adult dose for rapid sequence intubation (RSI) (25)

1.5 mg/kg IV bolus.


Adult dose for maintenance of sedation in mechanically ventilated patients (17)

0.3-3 mg/kg/hr infusion (usually started at 1-2 mg/kg/hr). 


Adult dose for procedural sedation (6, 19)

0.5 mg/kg IV

Indications


Mechanism of action and pharmacology

Overview


The active ingredient is 2,6-diisopropylphenol, an oily substance at ambient temperature that is not soluble in liquid solutions. On the contrary, propofol  is a highly lipophilic molecule which rapidly crosses the blood-brain barrier (13, 22).



Mechanism of action


Pharmacology



Propofol use in status epilepticus

Cautions




Propofol and allergy to eggs or soybean controversy

Propofol-related infusion syndrome (PRIS)



Pregnancy and lactation

Pregnancy risk classification (12, 25)


Comment:


Lactation

References

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