Medicinal Products

DIPRIVAN 2% Emulsion for injection 50 ml bottle

Generic drug of the therapeutic class: Anesthesia, resuscitation, analgesics
active ingredients: Propofol
laboratory: Astrazeneca

Injectable emulsion IV
All forms

Indication

a) ANESTHESIA :
- Propofol is an intravenous, fast-acting anesthetic agent that can be used for the induction and maintenance of anesthesia .
Propofol may be administered in adults, children and infants older than 1 month.
b) SEDATION :
- Propofol can be used for sedation of ventilated patients requiring intensive care in surgical or medical intensive care units.
- Reserved for adults and teenagers over 15 years old.

Dosage DIPRIVAN 2% Emulsion for injection 50 ml bottle

Shake the bottle before use.
I) GENERAL ANESTHESIA :
DIPRIVAN 2% should be used as an infusion to induce anesthesia only in patients who will receive it for the maintenance of anesthesia.
A) Induction :
a) In the adult and the elderly (over 65 years):
In patients, premedicated or not, it is recommended to administer the product by continuous infusion at an initial rate of 1 or 2 ml every 10 seconds until the narcosis is obtained.
Most patients younger than 55 years will require 1.5 to 2.5 mg / kg of propofol. The total dose required can be reduced by a lower rate of administration (20 to 50 mg / min, ie 1200 to 3000 mg / h).
In elderly patients, the dose required for induction of anesthesia should be reduced. This dose should be administered slowly and titrated according to the response.
It is recommended not to exceed 1.5 mg / kg after 75 years.
b) In children:
The dosage should be adjusted according to the weight and age of the child. The following dosages may be used:
- 1 month to 3 years : 3 to 5 mg / kg.
- > 3 years to 8 years : 2.5 to 4 mg / kg.
- > 8 years : about 2.5 mg / kg.
c) In patients whose general condition is impaired (ASA grade III or IV):
In patients whose general condition is impaired (ASA grade III or IV), lower rates of administration will be used: approximately 1 ml (20 mg) every 10 seconds.
In ASA IV patients, the induction dose should be less than 1.5 mg / kg (see warnings and precautions for use).
Further reduction in dose and rate of administration will be required in elderly ASA grade III or IV patients.
B) Interview :
It will be performed by administering propofol on demand, depending on the depth of anesthesia desired.
Diprivan 2% is not suitable for repeated bolus injection, in this case use Diprivan 1%.
a) In the adult and the elderly (over 65 years):
In adults, the average dosage varies from one patient to another, but is generally in the range of 0.1 to 0.2 mg / kg / min (6 to 12 mg / kg / h).
In the case of over 55 years the dosage will generally be lower. In the elderly, the infusion rate or target concentration should also be reduced.
Fast (simple) bolus administration should not be used in the elderly, as it may lead to cardiorespiratory depression.
b) In children:
In continuous infusion, in infants 1 months and older and in children, the average administration dose varies considerably between children but is generally between 9 and 15 mg / kg / h (0.15 to 0.25 mg / kg / min).
The doses necessary for the maintenance of anesthesia are all the higher as the child is younger.
c) In patients whose general condition is impaired (ASA grade III or IV):
In the subject ASA grade III or IV, the dosage will generally be lower.
Further reduction in dose and rate of administration will be required in elderly ASA grade III or IV patients.
II) SEDATION :
The use of propofol for sedation of children under 15 is contraindicated (see contraindications).
Administration of DIPRIVAN 2% in repeated injections is not recommended.
When used in sedation in patients requiring intensive care, it is recommended to administer propofol as a continuous infusion.
The dosage should be adjusted according to the depth required for sedation. For most patients, sufficient sedation is obtained with doses ranging from 1 mg / kg / h to 4 mg / kg / h (see warnings and precautions for use).
In the elderly, the dose and rate of infusion or target concentration should be reduced.
If the patient concomitantly receives other intravenous lipids, a reduction in the amounts administered should be made to take into account the amounts of lipids provided by DIPRIVAN: 1 ml of DIPRIVAN 2% (20 mg of propofol) contains 0.1 g of lipids.
III) GENERAL RECOMMENDATIONS :
- Induction:
Propofol may be administered in the terminal part of the tubing of a 5% isotonic glucose infusion, 0.9% saline or a 4% glucose and 0.18% saline mixture (see incompatibilities).
- Extended administration (maintenance of general anesthesia and / or sedation):
Analgesics are usually needed in combination with this medication. This product has been used in combination with spinal and epidural anesthesia as well as most anesthesia products: premedications, muscle relaxants, inhalation anesthetics and analgesics. No pharmacological incompatibility was encountered. Under these conditions, lower dosages of propofol are needed.
. If DIPRIVAN is administered pure, an electric syringe pump or volumetric flow controlled pump should be used.
. DIPRIVAN 2% should not be diluted.

Against indications

CONTRAINDICATED:
- Known hypersensitivity to propofol or to any of the constituents of this product.
- CHILD:
Propofol is contraindicated for the induction and maintenance of anesthesia in children under 1 month of age.
Propofol is contraindicated in patients under 15 years of age for sedation in the Intensive Care Unit (see warnings and precautions for use).
- BREASTFEEDING:
The use of propofol in nursing women is not recommended.
NOT RECOMMENDED :
The use of propofol is not recommended in ASA IV patients because of cardiovascular depressant effects.

Diprivan side effects

- Systemic: rare, both during induction and maintenance and awakening.
Some cases of bradycardia, sometimes severe, and asystolies have been reported (see warnings and precautions for use).
Exceptionally, have been reported:
. A clinical presentation of anaphylactic shock may include angioedema, bronchospasm, and erythema accompanied by severe hypotension.
. Pulmonary edema.
. Epileptiform movements, including opisthotonos and seizures, in connection with the administration of propofol. These movements can occur during anesthesia and at the end of anesthesia.
. Cases of post-anesthetic fever.
. A change in urine staining as a result of prolonged administration of propofol.
. Due to the presence of soybean oil, there is a risk of hypersensitivity reaction (anaphylactic shock, urticaria).
Induction is, as a general rule, gentle with a minimum of excitation. On waking, nausea, vomiting and headache were observed in only a small proportion of cases. A non-watchful phase can also be observed (see warnings and precautions for use).
In repeated administration, moderate thrombocytopenia could be observed and attributed to the lipid vector.
Very rare cases of rhabdomyolysis, metabolic acidosis, hyperkalemia or heart failure, sometimes fatal, have been observed during the administration of propofol for sedation Intensive Care Unit at doses greater than 4 mg / kg / h (see warnings and precautions for use).
Rare cases of pancreatitis have been observed when using Diprivan.
- Local: A pain at the place of injection of the product can be largely attenuated by using the large veins of the forearm and the fold of the elbow. In children, the pain is even more frequent than in adults, especially when the injection is made in a small vein of the hand or wrist, it is less in a vein of the bend of the elbow or the front. arms.
Venous complications are exceptional. Accidental extravasations observed, as well as animal studies, showed only a minimal tissue reaction. Intra-arterial injection in animals did not cause tissue complications locally and downstream.

Popular Posts

Category Medicinal Products, Next Article