Propofol and drug overdose

detroitdano · Jul 13, 2011

Off the top of my head, I would say because it's so short-acting. You could have someone on Fentanyl and Versed for days and when you turn it off they're groggy for a long time afterward. Propofol quickly wears off once it's shut off. In a drug OD patient they're going to be somnolent enough, better to use a drug that won't add to that problem.

funkywoman · Jul 14, 2011

also would work well in er setting to quickly sedate in order to evaluate/treat without looking at lasting side effects

allnurses Guide · Jul 14, 2011

Propofol is the shortest acting of most commonly used sedating drugs. Also, propofol is the only other common sedating drug that is also metabolized outside the liver.

ckh23, BSN, RN · Jul 14, 2011

In addition to the above, if it's someone who is a chronic drug abuser, they usually have a high tolerance to the fentanyl, ativan/versed gtts and it's hard to get them adequately sedated.

ICUenthusiast · Jul 14, 2011

Thanks for the input! I was able to talk to someone last night with expertise in the area and they said its the choice drug mainly because of its short half-life. It proved helpful when trying to do some spontaneous breathing trials especially...

Although, the fact it's metabolized outside the liver is a great point I didn't consider. Afterall, many of drug ODs come in with very nicely elevated liver enzymes, propofol would probably be the nicer thing to do for their liver heh.

Unfortunately, we don't get to use propofol very much in my area. It's largely been phased out for floor use for reasons that don't seem to make all that much sense.

Do any of you see it with DT's then? When looking up information for the drug OD and propofol, I saw a few studies about using it for DT's (just for sedation, while ativan still needed for seizures?) and its possible superiority over ativan for DT's.

detroitdano · Jul 14, 2011

I've only used Propofol for a patient in DT's who was tubed and bucking the vent and staring the staff down on 20 of Versed and 200 of Fentanyl. As soon as 15 of Propofol was in his system, lights out. It's such an amazing drug. Typically for our EtOH'er's we use Ativan only.

hodgieRN · Oct 10, 2011

And that propofol is not a narcotic or benzo, it's simply an anesthetic. For drug overdoses, you basically keep them intubated until they wake up. Propofol keeps them sedated until the narcotics wear off.

sapphire18 · Oct 10, 2011

I don't see why you would use propofol on the floor unless you have vents...never seen a pt on propofol that wasn't vented. Also, it takes a lot of monitoring since it's such a powerful sedative.

Rebecca Edwards · Oct 11, 2011

Age: 39

Years Exp:19

Nursing Specialty: TICU/SICU/MICU/CVICU/ER

In our facility we use Propofol frequently...the only time I have ever seen it used on the floor is during a code situation and the ICU RN is pushing it. Versed is a great medication but versed can hang around in fat cells up to seven days...especially in patients with ARF.