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Propofol Extrahepatic Metabolism — FRCA Primary MCQ

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HardPharmacology - Intravenous AnaestheticsPropofol Extrahepatic MetabolismFRCA Primary

During a propofol infusion, cardiac output falls markedly after induction. Which pharmacokinetic change is most likely?

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Correct answer: C — Propofol clearance decreases because it is blood-flow dependent

The best answer is “Propofol clearance decreases because it is blood-flow dependent”. The current UK SmPC states that propofol clearance is blood-flow dependent. A clinically important fall in cardiac output can therefore reduce clearance and increase exposure at an unchanged infusion rate. Distribution, metabolism and pharmacodynamic effect do not become independent of dose or flow.

Reference: Propofol 1% emulsion, Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/15152/smpc