Triglycerides Propofol

Ward, D.S., Norton, R.J., Guivarc h, P.-H., Litman, R.S. Bailey, PL. (2002) Pharmacodynamics and pharmacokinetics of propofol in medium-chain triglyceride emulstoresthesiology, 97 140-1408. 

Propofol is a short-acting intravenous induction agent, which is dissolved in a mixture of long-chain triglycerides and soya bean emulsion. It is now in general use in daycare anesthesia and is being increasingly used in infusions in intensive care units. Recovery from anesthetic doses compares favorably with that after enflurane and isoflurane (1). 

A 51-year-old woman with a past medical history of a seizure disorder, schizophrenia, and asthma, who had been admitted with pneumonia, was sedated using a propofol infusion to assist mechanical ventilation (65). Over 7 days she received a total of 26.5 g of propofol at a maximum rate of 0.2 mg/kg/minute. When pancreatitis, which was associated with hypertriglyceridemia, was diagnosed, the propofol infusion was stopped. In addition to raised amylase activity, serum triglyceride concentrations peaked at 17 mmol/1 and lipase activity at 564 U/1. She recovered over the next 7 days. On day 17 she underwent tracheostomy revision, during which... 

Schaub E, Kern C, Landau R. Pain on injection a double-blind comparison of propofol with lidocaine pretreatment versus propofol formulated with long- and medium-chain triglycerides. Anaesth Analg 2004 99 1699—1702. 

Traditionally, emulsions have been used to deliver oils (castor oil, liquid paraffin) in a palatable form. This is now a minor use, but there is a growing interest in the possibility of improving delivery by the use of lipid o/w emulsions as vehicles for lipophilic dmgs (e.g. diazepam, propofol) for intravenous use. Griseofulvin, presented as an emulsion, exhibits enhanced oral absorption an emulsion of indoxole has superior bioavailability over other oral forms. Medium-chain triglycerides and mono- and diglycerides promote the absorption of ceftriaxone and cefoxitin as well as ciclosporin. 

Fat emulsions are used to supply a large amount of energy in a small volume of isotonic liquid they supply the body with essential fatty acids and triglycerides. Fat emulsions for intravenous nutrition contain vegetable oil and phospholipid emulsifier. Several commercial fat emulsions are available, such as Intralipid, Lipiphysan, Lipofundin and Lipo-fundin S. They contain either cottonseed oil or soybean oil. In Intralipid, for example, purified egg-yolk phospholipids are used as the emulsifiers, and isotonicity is obtained by the addition of sorbitol, xylitol or glycerol. Intralipid has also been used as the basis of an intravenous dmg carrier, for example for diazepam (Diazemuls) and propofol (Diprivan), as an alternative to solubilisation in nonionic micellar systems such as Cremophor EL. 

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