Tuesday, July 07, 2009

Propofol


Propofol, aka "milk of amnesia" (it actually looks like milk) is a wonderful drug to use in the ER. It rapidly produces a state of amnesia and analgesia and lasts a few minutes in the proper dosage. I use it to reduce dislocated shoulders, jaws, elbows, hips, and to maintain sedation while a patient is intubated and on the ventilator. If properly dosed it usually does not affect one's blood pressure very much and does not cut the respiratory drive and, after whatever painful procedure I need to do is done the patient slowly awakens over the next five minutes or so. They usually ask me when I'm going to fix their messed up whatever and I tell them it's done and they don't believe me. Awesome drug.

So I'm just kind of wondering what it was doing in a private residence of a certain celebrity who just died an untimely death? In fact, in a brief search of a reference I happen to have nearby the ONLY indications for it's use are for induction of anesthesia, maintenance of anesthesia, or procedural sedation (and some would argue the last indication). Also, it has a whole list of dangerous reactions when combined with opiates like methadone, dilaudid, demerol, morphine, fentanyl and the like. In fact, the combination can cause, well, death.

I wonder what the HELL it was doing there? I mean, was this particular celebrity dislocating his hip every day with all the moonwalking and thriller dancing? I am not even aware of it being a popular drug of abuse on the street though I may be wrong here. Turns out what it is good for is for putting people into an unconscious state for a few minutes while you do painful things to them and having the added benefit of them having no memory for the painful event. Just wondering, maybe you readers have some ideas?

23 comments:

  1. Ain't that amazing! I heard that yesterday and was astounded! I predict that some doc is about to lose a license.

    I had heard that MJ was having trouble sleeping (maybe someone took away the little boys that he was so fond of cuddling with). Possibly he was substituting "anesthesia" for sleep. Or, maybe skin lightening is a painful procedure.

    I saw a magazine at the grocery store tonight that headlined the "tragic" death of Jackson.

    Untimely, maybe. But, tragic??? Have we lost all semblance of what a tragedy is?

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  2. Another idea......

    Maybe it was to help him forget about Mccully Culkin!?!

    Propofol is an amnestic!

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  3. doc,
    great points. the 'tragic' death can be debated but i think 'pitiful' is more appropos. it also get's my head all in a twist when whatever celebrity happens to be dying at he time is immediately branded as 'heroic'. so and so's 'heroic' battle with cancer. maybe that particular person is battling heroically, but simply dying is not heroic unless one can simply die and give comfort to those grieving before it happens.

    here's heroic. my neighbor who has deployed to iraq 9 times and could have retired years ago putting himself in the crosshairs again and again. here's heroic, a single mom working three jobs to give her kid a better life.

    so yes, we have so polluted the language with hyperbole that new words and adjectives need to be used to describe the formerly 'heroic' and 'tragic'.

    i will end this heroic post now and take care of a tragic nasal laceration.

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  4. chronic insomniac. perhaps an anesthetic is in order because Im tired of being heroic and waking after 3 hours of sleep everyday.

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  5. C.
    i think you are being sarcastic but for those who wonder if this medicine would be a good sleep agent the answer is an emphatic 'no'.
    best

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  6. C.

    Your tale is truly a "tragedy".

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  7. Slightly off topic, but I've heard for about a week(seems like years) how very CLOSE friends and family are just devistated about MJ's death. If the guy was in such bad shape, then where were they?
    It is as if they saved up their concern about him for the cameras, no that couldn't be it.

    AC

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  8. Ok here's a different take on that bottle of crap they found? He wasn't taking it.. he was using it on the kids... Hmmm no "memory of why my body aches in funny places mommy". Just saying.......yeah, 7 Soldiers died that day in Afghanistan, where is the tragically heroic outrage? the flowers? the parades? the tears? their names at least?

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  9. AC, I already heard their alibi. You know that they tried, but it was the fault of those around Jackson (like the doc that he had on retainer). Oh, what a tragedy.

    Gia, if he was using it on the kiddos, then I wonder who was starting the IV's and monitoring the vitals? Propofol is powerful stuff. Your comment about TRUE heroes is poignant. Thank you.

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  10. Gia, Gia, Gia,
    EVERYONE knows you use Rohypnol for Date Rape.... Propofols not a scheduled drug anymore than Lipitor or Viagra... It was probably Bubble's the Chimps stash... You know it was that Monkey that bit off Jacko's nose.

    Frank

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  11. Propofol hurts like a MOFO when it's injected. My gaspasser buddy says he always mixes it with lidocaine. When I use it, it usually goes through a central line.

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  12. So what your saying is it can only be given via IV and not directly into the vein?
    I guess the track marks found are from narcs.

    What a wierd twisted existance this man lived. And once a child molester, always a child molester.

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  13. very short acting benzo..Valium family

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  14. Come on people!! This MegaFag/Pedophile(OJ is innocent too) was killed by an idiot, non-licensed or board certified "cardiologist" in his home..
    Think about it a second..The "dr" rushes to say he wasn't injecting Mikey with "demerol"..Maybe sounds like "propofol"?? Or the generic name "Diprovan" Starts with a D..
    I've had this drug administered to me 6 or 7 times, in the ED, with every known vital sign monitor connected to me. Puts this big boy in LaLa land at 1mg/kg. They then cardiovert me from a nasty heart rytythm(read ELECTROCUTE)and I know/remember NOTHING!! My nurses make jokes about what I say or get me to call my wife before I'm fully awake, etc..I mean this stuff is great!!
    Oh, and it's not related to demerol, morphine, vicodin, etc..So let's give it to Mikey to let him sleep, poor baby. (He's an addict so the others won't work anymore anyway)..Can't shoot it in a muscle(like he had any)..Got to give it IV..My good "dr" is right here, only propofol has no ANTIDOTE! Not like morphine, can't be reversed!
    And I can guarantee you this crackpot has no malpractice insurance, so good luck Jackson's!!
    And, any doctor with a DEA license(completely different froma medical license) can order this shit ONLINE!! To whatever address is on his DEA certificate!!
    Oh My, Oh My, Mikey's still asleep..Thank the Lord..

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  15. Come on Old Fart, say what you really think. Stop equivocating.

    Cholera: I've never given it through a central line. I've never had anyone stay awake long enough to complain too much about burning with infusion. If MJ was receiving it (or any other parenteral drugs) frequently, one wonders if he had a permanent indwelling central line? Autopsy report will be interesting.

    peedee: IV and into the vein are, of course, the same thing. I think maybe you're asking about "shooting it" or as we would say "giving it in a bolus". It doesn't do much sustained good to "bolus" the drug as it has such a short duration (minutes). If you want any sustained effect, you would have to repeatedly inject it (which is very inexact and inefficient). Therefore after the initial loading dose, a maintenance infusion is usually begun.

    -85

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  16. Well in the long run, there are so many worthier things to try to figure out, I for one, am not EVER gonna wonder again... I DON'T CARE if he was given this by a non cerified doctor or by the monkey himself. He died as he lived, like a freak, instead of maybe helping someone besides himself and feeling good that way, he chose debauchery. Good riddence to bad rubbish, to steal a line from Alice in Wonderland! (ha how apropriate!)

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  17. Being in California, I was greatly irritated that Rush was prempted so we could instead hear all of Hollyweird blubber their goodbyes to this skank shadow of a human waste over at Staple Center. Good lord, what have we become?

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  18. Born and raised in Miami, no, Propofol has never been abused, at least down here. And EVERYTHING that can be abused has been where I'm from.


    From Banana peels to Ketamine, if it's available it will be taken.

    (And yes, I know you cant get high from Banana peels, but way to many people I went to school with tried)

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  19. I am just happy I don't work in the hospital they took him to.

    And Diprivan is the brand name...propofol is generic.


    And I guess, he felt with 'who he is' he should get anything he wanted and found some quack to do it for him.

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  20. I thought maybe they had it because he was having his plastic surgery done at home...

    Regardless he was a freak, and he made some really bad choices in life but nobody ever held HIM responsible, not even a jury of his peers.

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  21. I guess there is such a thing as too much access to medicine.

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  22. Good catch Ardosa! A bottle of Diprofol is in the mail to U..

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