5.4Intravenous Induction Agents
- All benzodiazepines and intravenous induction agents are GABAA receptor allosteric modulators augmenting GABA function (Figure 5.12)
- Except ketamine
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Propofol
- Clinical Indications
- General anesthesia induction
- 2–4 mg/kg IV
- Intravenous infusion
- Antiemetic
- Antiepileptic
- General anesthesia induction
- Cerebral
- ↓ CBF
- ↓ CMRO2
- Antiemetic
- Antiepileptic
- Cardiovascular
- ↓ CO
- ↓ MAP
- ↓ SVR
- ↓ Baroreceptor reflex
- Pulmonary
- ↓ TV
- ↓ RR
- Renal
- Minimal
- Hepatic
- Primary site of metabolism
- Contraindications
- Poor cardiac reserve
- Especially with induction dosage
- Not contraindicated with egg, soy, or peanut allergies [28]
- Poor cardiac reserve
- Board Facts
- Pain on injection
- Can be attenuated with lidocaine [29]
- Lipid vehicle supports bacterial growth
- Fospropofol
- H2O soluble prodrug
- Decreased burning sensation on injection
- Pain on injection
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