Propofol Abuse Growing Problem for Anesthesiologists - page 5

by Anxious Patient | 20,784 Views | 64 Comments

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  1. 0
    Quote from cardiacRN2006
    That's right. At 12 hours, whatever is left in the bottle is tossed and replaced. Doesn't happen very often, except for those on low doses. Usually we change the tubing a little early, etc.

    But, I have tossed a partially full bottle of propofol in the garbage before.
    I have too. When I was a new RN, I tried to waste it with someone. It takes about 5 to 10 minutes to get the top off to pour the waste out. Since no one mandates to waste it, I don't anymore. Just not user friendly to get the top off.
  2. 0
    Quote from hypocaffeinemia
    Question for our CRNAs:

    What's this about aerosolized propofol? Just how much is actually excreted via lung, if any? And with the closed circuits of ventilators, how is this even an issue worth mentioning?
    I was wondering the same thing. I would think that there would be a much bigger problem from the anesthetic gases rather than aerosolized propofol or fentanyl.
  3. 3
    Propofol - Ah yes....."Milk of Amnesia".

    The aerosolization debate is a little puzzling to me, because all the patients that I administer Propofol to are intubated and on a vent. The vents have filters. Hmmm....

    The hospital that I work at in California (as well as many surrounding hospitals) do not allow meds to be flushed down the drain anymore. We have oversized containers especially for medicine waste in order to have an alternative to the drain - too many fishes with extra eyeballs being found in the streams apparantly.
  4. 0
    Quote from KimQCRNA
    Dear NurseKitten:
    It wouldn't be hard to slip an LMA in and bag him until he comes back breathing...hope they have suction and a pulse ox...NPO status is always a question....and yes it does sound like a pretty good TIVA until the propofol wears off (quickly), I just don't see them doing an infusion.... and then the danger of aspiration if there is an LMA in...as well as laryngospasm...and doubt if the at home doc knows what to do about that...maybe just an oral airway with some supplemental O2......and exactly WHAT training does this so called doc have?? I heard he was a cardiologist......and last time I checked, they don't get a lot of anesthesia training in their fellowship..........
    And these were ALL things we talked about...but an infusion would be the only way he could "get some sleep", albeit non-REM.

    It will VERY interesting to see what comes back on his tox screen, given that it's such a lipophilic drug, it would have to be in the tissues.

    Thanks for your confirmation that we weren't completely all wet when we were parsing it apart for lack of anything else to do.
  5. 0
    Quote from hypocaffeinemia
    Question for our CRNAs:

    What's this about aerosolized propofol? Just how much is actually excreted via lung, if any? And with the closed circuits of ventilators, how is this even an issue worth mentioning?
    First of all, Azhiker: Apology accepted, and thank you. I didn't realized half of what anesthesia did until I got into this a ways - it's fascinating and scary at the same time.

    I have looked in two of my anesthesia textbooks and don't have my Barash (THE sourcebook for boards) here with me, but I don't see anything about it.

    Just sent an e-mail to our pharm instructor who is also a CRNA. She's pretty amazing, and if there's anything to it, I'm willing to bet she knows.
  6. 0
    Quote from cingle
    Scary...isn't this the drug that's being mentioned in some news articles of Michael Jackson's death as something he MAY have been using for unremitting insomnia?

    This explains the cardiac arrest. It is a shame that someone provided this or any drug to Michael.
  7. 0
    Certainly propofol would explain his death, if it were given to him. We are still weeks away from the toxicology results and lacking any news, the reporters are engaging in guessing.
  8. 0
    Quote from DolceVita
    I always wondered about the poppy seed excuse....
    believe it or not, it really is true.

    they did an experiment at the rehab i went to. they had a patient go out for a pass and tested him on return (per policy after passes out with family). he tested positive for pot.

    they were going to kick him out of the program. but he had been so into his treatment, one of the few they thought really had "got it".

    so they did an experiment on the guy after he tested negative for pot a few days later. they had him eat poppy seed rolls. they had him void after ever roll. it only took 2 small rolls for him to test way positive.

    i thought that was kinda neat to know.


    when i was under contract with peer i couldnt eat arby's beef and cheddar because of the poppy seeds on the bun. i didnt want it on a sesame bun because it wasnt the same. i know, im wierd. so as soon as i graduated, i ate 2 of them, lol
  9. 0
    Quote from PlaneFlyerRN
    Propofol - Ah yes....."Milk of Amnesia".

    The aerosolization debate is a little puzzling to me, because all the patients that I administer Propofol to are intubated and on a vent. The vents have filters. Hmmm....

    The hospital that I work at in California (as well as many surrounding hospitals) do not allow meds to be flushed down the drain anymore. We have oversized containers especially for medicine waste in order to have an alternative to the drain - too many fishes with extra eyeballs being found in the streams apparantly.
    i worked with a doc that called it "milk of make you sleep" that always cracked me up, lol
  10. 0
    Quote from cardiacRN2006
    Propofol?
    I dont' get it! I mean, it wears off in like, 36 seconds. How could it be used for insomnia?

    And yep, we just toss it in the trash when we're done...I never thought of people abusing it. I mean, propofol?

    Bizarre.
    i dont get using it at work for sure! the whole point is to NOT get caught stealing drugs isnt it? taking something you KNOW you will pass out from in seconds? i just dont get it.

    when my first husband was in ICU with sepsis and ARDS 13 yrs ago they had to use propofol on him because versed was contraindicated with porphyria. it came in a box of 12 PCA syringes. they just left the box sitting out in his room. nothing to sign out, threw away whatever wasnt used.

    so i was shocked when i heard MJ abused it. even though i'm an addict, that is something i would have never thought about stealing or even trying.

    the whole thing is so strange. but it makes all the different surgeries and hospitalizations make more sense to me now.


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