Evaluation of a fatal propofol intoxication due to self administration

Klausz, Gabriella; Róna, Kálmán; István, Kristóf; Törő, Klára

doi:10.1016/j.jflm.2008.12.010

Cited by 38 publications

(35 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The LLOQ criteria were fulfilled at the concentrations of 0.01 mg/L for propofol and 0.02 mg/L for propofol G in ante-mortem blood and 0.02 mg/L for propofol and 0.04 mg/L for propofol G in post-mortem blood ( Table 2). The LLOQ values obtained were well below the propofol concentrations reported in fatal cases of propofol self-administration [4][5][6][7][8][9][10]. The upper limits of quantification were 10 mg/L for propofol and 20 mg/L for propofol G, which correspond to the concentrations of these substances in the highest calibrant.…”

Section: Methods Performance Parametersmentioning

confidence: 65%

“…Propofol is also used recreationally, especially among health care professionals [3,4], due to its sedative and relaxing properties and potential sexual illusions and euphoric feelings [5]. Several cases of fatal propofol abuse or suicide due to single or combined drug intake have been reported [4][5][6][7][8][9][10]. In the fatal cases, the measured propofol concentrations in the blood were in the range of 0.08-8.7 mg/L.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous determination of propofol and its glucuronide in whole blood by liquid chromatography–electrospray tandem mass spectrometry and the influence of sample storage conditions on the reliability of the test results

Sørensen

Hasselstrøm

2015

Journal of Pharmaceutical and Biomedical Analysis

View full text Add to dashboard Cite

Section: Methods Performance Parametersmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Simultaneous determination of propofol and its glucuronide in whole blood by liquid chromatography–electrospray tandem mass spectrometry and the influence of sample storage conditions on the reliability of the test results

Sørensen

Hasselstrøm

2015

Journal of Pharmaceutical and Biomedical Analysis

View full text Add to dashboard Cite

“…3,4 Part of the propofol-induced respiratory depression is due to the activation of γ-aminobutyric acid (GABA) receptors in respiratory brainstem neuronal networks. 5,6 Here, we performed a study toward the development of pharmacological means for minimizing propofol-induced depression of respiration.…”

Section: Cx717 Reduces Propofol-induced Apneamentioning

confidence: 99%

Coadministration of the AMPAKINE CX717 with Propofol Reduces Respiratory Depression and Fatal Apneas

et al. 2013

View full text Add to dashboard Cite

Background: Propofol (2,6-diisopropylphenol) is used for the induction and maintenance of anesthesia in human and veterinary medicine. Propofol's disadvantages include the induction of respiratory depression and apnea. Here, the authors report a clinically feasible pharmacological solution for reducing propofol-induced respiratory depression via a mechanism that does not interfere with anesthesia. Specifically, they test the hypothesis that the AMPAKINE CX717, which has been proven metabolically stable and safe for human use, can prevent and rescue from propofol-induced severe apnea. Methods: The actions of propofol and the AMPAKINE CX717 were measured via (1) ventral root recordings from newborn rat brainstem-spinal cord preparations, (2) phrenic nerve recordings from an adult mouse in situ working heartbrainstem preparation, and (3) plethysmographic recordings from unrestrained newborn and adult rats. Results:In vitro, respiratory depression caused by propofol (2 μM, n = 11, mean ± SEM, 41 ± 5% of control frequency, 63 ± 5% of control duration) was alleviated by CX717 (n = 4, 50-150 μM). In situ, a decrease in respiratory frequency (44 ± 9% of control), phrenic burst duration (66 ± 7% of control), and amplitude (78 ± 5% of control) caused by propofol (2 μM, n = 5) was alleviated by coadministration of CX717 (50 μM, n = 5). In vivo, pre-or coadministration of CX717 (20-25 mg/kg) with propofol markedly reduced propofol-induced respiratory depression (n = 7; 20 mg/kg) and propofol-induced lethal apnea (n = 6; 30 mg/kg). Conclusions: Administration of CX717 before or in conjunction with propofol provides an increased safety margin against profound apnea and death. P ROPOFOL (2,6-diisopropylphenol) is used for the induction and maintenance of anesthesia in human and veterinary medicine. Propofol's favorable attributes are its pharmacokinetic properties that result in a rapid, clear emergence. Its disadvantages include the induction of respiratory depression, apnea, and blood pressure reductions.1,2 Furthermore, there are increasing reports What We Already Know about This Topic• Propofol depresses respiration partly due to the activation of γ-aminobutyric acid receptors within brainstem respiratory center AMPAKINEs effectively alleviates opioid-induced respiratory depression without interfering with analgesia in rodentsWhat This Article Tells Us That Is New Address correspondence to Dr. Greer: University of Alberta, Department of Physiology, Centre for Neuroscience, Women and Children's Health Research Institute, 3-020M Katz Building, Edmonton, Alberta, Canada T6G 2S2. john.greer@ualberta.ca. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology's articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.

show abstract

“…Should they retrain in another field? Although extended treatment and lifelong abstinence may at times seem like overkill with these particular short-timers, providing no treatment is commonly associated with a fatal outcome (Drummer, 1992;Chao et al, 1994;Iwersen-Bergmann et al, 2001;Roussin et al, 2006;Kranioti et al, 2007;Kirby et al, 2009;Klausz et al, 2009;Lee and Yoo, 2009;Yoo, 2009). Taken in total, these cases suggest that addiction treatment in such cases should include a focus on comorbid conditions and trauma resolution (if present), layered on top of traditional addiction care.…”

Section: Treatment and Workplace Issuesmentioning

confidence: 99%

Addiction to Propofol

Earley¹,

Finver²

2013

Journal of Addiction Medicine

View full text Add to dashboard Cite

This study suggests the incidence and/or detection rate of propofol abuse in HCPs is increasing. Women and anesthesia personnel were overrepresented in the propofol cohort. Propofol-dependent patients commonly have a history of depression and earlier life trauma. A rapid downhill course and physical injury are common adverse effects of propofol abuse. The time from initial use to treatment entry is often contracted when compared with other drugs of abuse making the diagnosis of a true dependence disorder and disposition after treatment more difficult.

show abstract

Evaluation of a fatal propofol intoxication due to self administration

Cited by 38 publications

References 15 publications

Simultaneous determination of propofol and its glucuronide in whole blood by liquid chromatography–electrospray tandem mass spectrometry and the influence of sample storage conditions on the reliability of the test results

Simultaneous determination of propofol and its glucuronide in whole blood by liquid chromatography–electrospray tandem mass spectrometry and the influence of sample storage conditions on the reliability of the test results

Coadministration of the AMPAKINE CX717 with Propofol Reduces Respiratory Depression and Fatal Apneas

Addiction to Propofol

Contact Info

Product

Resources

About