Pharmacological and clinical evidences on the potential for abuse and dependence of propofol: a review of the literature

@article{Roussin2007PharmacologicalAC,
  title={Pharmacological and clinical evidences on the potential for abuse and dependence of propofol: a review of the literature},
  author={Anne Roussin and Jean-Louis Montastruc and Maryse Lapeyre-Mestre},
  journal={Fundamental \& Clinical Pharmacology},
  year={2007},
  volume={21}
}
Propofol (2,6‐diisopropylphenol) is an intravenous short‐acting anaesthetic widely used for inducing and maintaining anaesthesia. Propofol is also being increasingly used for sedation. Beside medical use, propofol is abused for recreational purpose, mostly in medical professionals who are not informed of the risk of dependence to this compound. The aim of this review was to provide an overview of molecular, animal and clinical pharmacological data of the literature evidencing the potential for… 
The abuse potential of propofol
TLDR
Evidence is found to support propofol's abuse potential from a pharmacological and experiential standpoint with multiple reports describing tolerance, dependence, withdrawal phenomena, abuse, and death from recreational use.
Metabolic Profiles of Propofol and Fospropofol: Clinical and Forensic Interpretative Aspects
TLDR
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.
[Assessment of the addictive risk of propofol].
  • U. Bonnet
  • Medicine, Psychology
    Fortschritte der Neurologie-Psychiatrie
  • 2011
TLDR
Propofol is considered to be a primary mental addictive substance that is characteristically intravenously consumed by persons within the medical profession and is only reflected insufficiently in the scale of Griffith and Johnson.
A Case Report of the First Propofol Addiction in Turkey.
TLDR
This report presents the case of a propofol-dependent patient who was an emergency medicine doctor with no difficulties in obtaining the drug and his death, which was suspected to have occurred owing to drug intoxication in the hospital in which he worked.
Clinical Effects and Lethal and Forensic Aspects of Propofol *
  • R. Levy
  • Medicine
    Journal of forensic sciences
  • 2011
TLDR
Because propofol has the potential for diversion with lethal consequences, the forensic scientist must have a basic understanding of its clinical indications and uses, pharmacologic properties, and detection methods.
Deaths from recreational use of propofol in Korea.
Abuse potential assessment of propofol by its subjective effects after sedation
TLDR
It is concluded that propofol functions as a reward; that patients enjoy its acute effects; and that no residual after-effects should arise.
A Case of Stress-Induced Cardiomyopathy after Propofol Anesthesia
TLDR
A 25-year-old woman without cardiovascular risk factors who developed stress-induced cardiomyopathy after propofol injection for anesthesia and was treated with conservative treatment is described.
Propofol abuse among healthcare professionals
TLDR
A multilateral approach to stem the rising tide of propofol abuse among HCPs is needed: a combination of preventative education, early identification and intervention, aggressive treatment, and consistent rehabilitation.
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References

SHOWING 1-10 OF 79 REFERENCES
Propofol dependency after treatment of tension headache
TLDR
This is the first reported case of prop ofol dependency in a lay person, and one should be aware of the abuse potential of propofol with regard to its growing use outside the context of general anaesthesia.
Propofol dependency in a lay person.
TLDR
A case of a 25-yr-old man with attention deficit hyperactive disorder (ADHD) who experienced propofol dependency and, under remarkable circumstances, succeeded in providing himself with this drug on a regular basis is reported.
Death after excessive propofol abuse
TLDR
The results of the investigation suggest that death was not caused by a propofol overdose but by respiratory depression resulting from overly rapid injection.
Acute pancreatitis induced by short‐term propofol administration
TLDR
A case of a drug‐induced acute pancreatitis that was most likely triggered by a single dosage of propofol is reported in a young girl who underwent elective magnetic resonance imaging.
Elevated Pancreatic Enzymes after Extended Propofol Therapy
TLDR
A 28‐year‐old man who suffered a severe head injury developed elevated pancreatic enzymes after receiving extended high‐dosage propofol therapy and intensive care practitioners should be aware of this potential reaction.
Pharmacological properties of ketamine.
TLDR
Little is understood of ketamine as a recreational drug and potential drug of dependence, but studies have shown potential for tolerance to and physical dependence on ketamine, further investigation of these phenomena is needed.
Acute pulmonary edema after intravenous propofol sedation for endoscopy in a child.
TLDR
A pediatric case is reported in which the administration of propofol was associated with acute pulmonary edema before gastrointestinal endoscopic examination.
Withdrawal syndrome after propofol
TLDR
It is felt that it would be imprudent indeed to dismiss outright the possibility of drug dependency and its attendant hazards after prolonged infusions of propofol, and it is believed that the temporal association of propOfol discontinuation and the development of the classical symptomatology of a general depressant withdrawal syndrome seriously implicate prop ofol in a causative role.
Determination of chronic abuse of the anaesthetic agents midazolam and propofol as demonstrated by hair analysis
TLDR
Repetitive consumption of the two anaesthetic agents during the last 6 months before the death was demonstrated and self-administration of midazolam and propofol without respiratory assistance and medical control certainly contributed to the death.
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