Metabolic Profiles of Propofol and Fospropofol: Clinical and Forensic Interpretative Aspects

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Ricardo Jorge Dinis Oliveira (Author) FMUP

Journal

Title: BioMed Research International

Vol. 2018

Pages: 1-16

ISSN: 2314-6133

Publisher: Hindawi

Indexing

ISI Web of Knowledge - 36 Citations

Other information

Authenticus ID: P-00R-AHX

DOI: 10.1155/2018/6852857

Abstract (EN): Propofol is an intravenous short-acting anesthetic widely used to induce andmaintain general anesthesia and to provide procedural sedation. The potential for propofol dependency and abuse has been recognized, and several cases of accidental overdose and suicide have emerged, mostly among the health professionals. Different studies have demonstrated an unpredictable interindividual variability of propofol pharmacokinetics and pharmacodynamics with forensic and clinical adverse relevant outcomes (e.g., pronounced respiratory and cardiac depression), namely, due to polymorphisms in the UDP-glucuronosyltransferase and cytochrome P450 isoforms and drugs administered concurrently. In this work the pharmacokinetics of propofol and fospropofol with particular focus on metabolic pathways is fully reviewed. It is concluded that knowing the metabolism of propofol may lead to the development of new clues to help further toxicological and clinical interpretations and to reduce serious adverse reactions such as respiratory failure, metabolic acidosis, rhabdomyolysis, cardiac bradyarrhythmias, hypotension and myocardial failure, anaphylaxis, hypertriglyceridemia, renal failure, hepatomegaly, hepatic steatosis, acute pancreatitis, abuse, and death. Particularly, further studies aiming to characterize polymorphic enzymes involved in the metabolic pathway, the development of additional routine forensic toxicological analysis, and the relatively new field of "omics" technology, namely, metabolomics, can offer more in explaining the unpredictable interindividual variability.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 16