Propofol interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Propofol needs care, as documented in this source.

• Cardiomyopathies

  Major

  Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

  4 sources

  1. Deutschman CS, Harris AP, Fleisher LA "Changes in heart rate variability under propofol anesthesia: a possible explanation for propofol-induced bradycardia." Anesth Analg 79 (1994): 373-7
  2. Warden JC, Pickford DR "Fatal cardiovascular collapse following propofol induction in high-risk patients and dilemmas in the selection of a short-acting induction agent." Anaesth Intensive Care 23 (1995): 485-7
  3. "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals (2001):
  4. Mackay P "Fatal cardiovascular collapse following propofol induction in high-risk patients." Anaesth Intensive Care 24 (1996): 125-6

• Deficiency Diseases

  Moderate

  Reports of mean urinary zinc loss during propofol therapy was approximately 2.5 to 3.0 mg/day in adult patients and 1.5 to 2.0 mg/day in pediatric patients. Practitioners should consider the administration of supplemental zinc during prolonged therapy with propofol in patients who are predisposed to zinc deficiency, such as those with burns, diarrhea, and/or major sepsis. Monitoring is recommended in these patients.

  1 source

  1. "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals (2001):

• Hyperlipidemias

  Moderate

  Propofol is formulated in an oil-and-water emulsion and elevated triglycerides can occur during extended therapy. Propofol should be administered cautiously in patients with lipid disorders such as primary hyperlipoproteinemia, diabetic hyperlipemia, and pancreatitis. Each milliliter of propofol contains 0.1g of fat (1.1 kcal).

  2 sources

  1. "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals (2001):
  2. Mateu J, Barrachina F "Hypertriglyceridaemia associated with propofol sedation in critically ill patients." Intensive Care Med 22 (1996): 834-5

• Kidney Diseases

  Moderate

  At high doses (2-3 grams per day), EDTA has been reported, on rare occasions, to be toxic to the renal tubules. Studies to-date, in patients with normal or impaired renal function have not shown any alteration in renal function with propofol Injectable Emulsion containing 0.005% disodium edetate. In patients at risk for renal impairment, urinalysis and urine sediment should be checked before initiation of sedation and then be monitored on alternate days during sedation.

  1 source

  1. "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals (2001):

• Seizures

  Moderate

  Patients with seizure disorders are at increased risk of seizure activity during the recovery phase of sedation or anesthesia following administration of propofol. Clinical monitoring of seizure activity is recommended in patients with or predisposed to seizure disorders.

  6 sources

  1. DeFriez CB, Wong HC "Seizures and opisthotonos after propofol anesthesia." Anesth Analg 75 (1992): 630-2
  2. Sutherland MJ, Burt P "Propofol and seizures." Anaesth Intensive Care 22 (1994): 733-7
  3. Samra SK, Sneyd JR, Ross DA, Henry TR "Effects of propofol sedation on seizures and intracranially recorded epileptiform activity in patients with partial epilepsy." Anesthesiology 82 (1995): 843-51
  4. "Product Information. Diprivan (propofol)." Astra-Zeneca Pharmaceuticals (2001):
  5. Cochran D, Price W, Gwinnutt CL "Unilateral convulsion after induction of anaesthesia with propofol." Br J Anaesth 76 (1996): 570-2
  6. Harrigan PWJ, Browne SM, Quail AW "Multiple seizures following re-exposure to propofol." Anaesth Intensive Care 24 (1996): 261-4