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What are the Phenol drugs?
Propofol
(Dirprivan, Rapinovet, Propoflo)
Propofol is used for __________ and acts similar to ___________.

At room temp it exists as a(n) ___________ and is prepared as a(n) ____________
induction and maintenance of general anesthesia
thiobarbituates

oil
1% emulsion
TRUE of FALSE

Porpofol is the world's largest selling injectable anesthetic.
TRUE
How is the emulsion of propofol made commercially available?
Intralipid (pH ~7.0)

Oil in water, oils, glycerol, lecithin
Formulation promotes rapid onset and recovery.
BUT has potential to Grow Microbes, cause Hyperlipemia, or be Painful upon injection.
How does propofol effect CNS?
Enhances GABA

Allosteric site (unique from others) to keep GABA open longer.
Synergistic with Benzodiazepines just like the barbituates were.
What is the principle effects of propofol?
Depress CNS activity
(faster than Thio - making it favorable for sedation in Outpatient and Diagnostic procedures)
How fast does propofol work?
How fast will the animal wake up?

Why?
Rapidly out (just like thio)
Awake REALLY FAST (5-10 minutes)

Rapid Hepatic Biotransformation and Immediate Renal Elimination.
First pass through lungs may even eliminate 28-61% of the drug.
Why is this speedy transformation and elimination really cool?
You can maintain anesthesia by putting the animal on a drip (or readministering) w/o worrying about significant accumulation in the body
Is propofol analgesic?
No - so put something on board for pain.
So what are 2 major uses for propofol given its characteristics?
Sedation for:
Non-Painful Dx -- (Ultrasound, Rads)

Therapeutics -- (Mech-Ventilation, Rads)
So propofol seems pretty cool... but can it help out with High Intracranial Pressure like barbituates did?
Yep, it does that too!
Decreases metabolic rate/O2 consumption and thus carries all of the associated benefits.
What other special effects does propofol have? (dos mas)
Anticonvulsive

Antiemetic (at subhypnotic doses -- mechanism unknown)
ADVERSE EFFECTS:

Respiratory System
Profound Resp Depression
Decrease Tidal Vol and RR
Transient Apnea

Inhibits Laryngeal Reflex (unlike barbs)
ADVERSE EFFECTS:

Cardiovascular System
Decrease systemic BP
*NOT accompanied by increase HR
(blocks sympathetic greater than parashympathetic)

NOT usually arrhythmogenic, but can augment catechol-arrhythmias
What's the glitch propofol has with about 10% of dogs and cats?
if used alone - there will be a Transient Excitatory phase
(limb paddling, nystagmus, twitching, myoclonus, opisthotonus)
Is volume of distribution greater for:

Barbituates or Propofol?
Propofol

RAPID redistribution!!
Propofol is a:

Strong / Weak ---- Acid / Base
Weak Acid
How does propofol exist in the plasma?
97-99% is bound to proteins (Albumin AND Hemoglobin) .... but this does not seem to slow down distribution and clearance.
Can propofol be used during C-sections?
Yes - it DOES cross into the placenta, but is rapidly eliminated from fetal/neonatal circulation.
How do liver and/or kidney disease impact the clearance of propofol?
Interestingly... they basically don't!

(could be due to lungs ability to clear)
Propofol is doesd based on _________

Thiobarbs are dosed based on _______
Propofol --- Body Weight

Thio --- Lean Body Mass
What's the deal with Propofol in Cats?
Repeat Admin over several days --> Oxidative Injury to RBCs (Heinz body)

Lung clears ~61% by 1st pass
What about propofol in special dog breeds?
Sighthounds - longer recovery

Greyhounds - smaller Vol-Dist and Clearance rate