Folenda

Induction & maintenance of general anesth. Used in ICU sedation & sedation for surgical & diagnostic procedures.

Induction of anesth Adult 10 mg/mL titrated at 20-40 mg every 10 sec until unconsciousness occurs. Most adults <55 yr would normally require a total dose of 1.5-2.5 mg/kg. Reduce total dose to 1 mg/kg, administered at slower infusion rate (approx 20 mg every 10 sec) in patients in risk groups ASA III & IV especially in the case of prior cardiac damage & elderly. Childn ≥1 mth 10 mg/mL slowly titrated until clinical signs of anesth is seen. Most childn >8 yr would likely require approx 2.5 mg/kg; higher dose may be required in childn 1 mth to 3 yr (2.5-4 mg/kg). Lower doses are recommended for ASA III & IV patients. Maintenance anesth Adult Continuous infusion 4-12 mg/kg/hr, or 4 mg/kg/hr in elderly patients in poor general state of health or w/ hypovolemia & patients in risk groups ASA III & IV. Repeat bolus inj 25-50 mg subsequent inj. Childn ≥1 mth Infusion or repeated bolus inj 9-15 mg/kg/hr. Childn 1 mth to 3 yr may require higher doses. Lower doses are recommended for ASA III & IV patients. Sedation during intensive care Patient >16 yr 0.3-4 mg/kg/hr by continuous infusion. Sedation for surgical & diagnostic procedures Adult Induction of anesth: 0.5-1 mg/kg for 1-5 min. Maintenance: 1.5-4.5 mg/kg/hr. In addition to infusion, 10-20 mg bolus inj may be given if a quick increase in the depth of sedation is necessary. Lower dose & slower administration may be necessary for ASA III & IV patients & patients >55 yr. Childn ≥1 mth Induction: 1-2 mg/kg. Maintenance: 1.5-9 mg/kg/hr. Can be supplemented w/ bolus inj of up to 1 mg/kg if rapid increase in the depth of sedation is required. Lower doses may be necessary for ASA III & IV patients.

Hypersensitivity. When general anesth or sedation is contraindicated. ICU sedation: Patient ≤16 yr.

Monitor patients for signs of decrease in BP, resp tract obstruction & O₂ deficiency. Risk of spontaneous movements during sedation; deadly resp complications if used w/o securing an airway; post-op unconsciousness, which may be accompanied by increased muscle tone; seizure in patients w/ epilepsy; exacerbation of mitochondrial disorder. Unconscious patient should be kept under intensive observation. Ensure that patient has fully recovered from anesth prior to discharge. Slower administration & particular caution in patients w/ cardiac, resp, renal & hepatic disorders, hypovolemia or who are in reduced general state of health. No vagolytic effect; has been associated w/ bradycardia w/ an occasionally severe outcome. Contains soybean oil which may trigger severe allergic reactions very rarely. May impair ability to drive & use machinery. Use of other sedatives or alcohol after propofol administration; concomitant use w/ drugs that reduce cardiac output or decrease heart rate. Pregnancy. Suspend breast-feeding for up to 24 hr after administration & discard corresponding breast milk. Not recommended in newborns. Elderly patients should not be given any bolus inj. ICU sedation: Associated w/ a series of metabolic disorders & organ failure. Risk of propofol infusion syndrome. Patients w/ lipid metabolism disorders. Not recommended w/ target-controlled infusion system administration.

Local pain during 1st inj. Spontaneous movements & muscle spasms during induction of anesth, headache during the waking phase; bradycardia; hypotension; hyperventilation & coughing during induction of anesth, temporary apnea during induction of anesth; singulation during the induction, nausea & vomiting during the waking phase; hot flushes during induction of anesth.

Pronounced decrease in BP w/ rifampicin. Apnea can occur more frequently & for a longer period of time w/ opiates. Lower doses may be necessary in patients taking valproate.

Anaesthetics - Local & General

N01AX10 - propofol ; Belongs to the class of other general anesthetics.

Rx