Propofol Sedative Puts Focus on Prescription Drug Abuse

By Heinrichs, Allison M | Tribune-Review/Pittsburgh Tribune-Review, July 1, 2009 | Go to article overview
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Propofol Sedative Puts Focus on Prescription Drug Abuse


Heinrichs, Allison M, Tribune-Review/Pittsburgh Tribune-Review


A powerful drug that quietly puts people to sleep for surgery is making headlines for its side-effects and possible abuse.

Propofol, sometimes nicknamed "milk of amnesia," is the drug of choice for outpatient surgeries because it takes effect quickly and wears off rapidly. It was the drug used by South Hills oral surgeon Dr. Robert Boyda, who was acquitted Wednesday of sexually assaulting patients under its influence, and the sedative is suspect in the death of entertainer Michael Jackson.

The government's drug czar warned Thursday that Jackson's death is a wake-up call to the nation about prescription drug abuse. Gil Kerlikowske, chief of the Office of National Drug Control Policy, said in an interview on CBS' "The Early Show" that more people are dying in the United States from drug overdoses than gunshot wounds.

Kerlikowske said he could not talk about Jackson's death while an official inquiry is under way, but emphasized it should alert people to the peril posed by powerful drugs that can save lives when used properly.

"It is the most frequently used intravenous anesthetic today," said Dr. Christopher Troianos, chairman of the department of anesthesiology at West Penn Hospital. He said its use began in the 1970s and became more common in the 1990s when a generic version came on the market.

It can be used as a general anesthetic to put patients into a deep sleep that stops breathing, or for sedation in outpatient procedures. Doses are based on the patient's weight, age and any cardiac or liver diseases, he said.

"For deeper levels of sedation, propofol has become the medication of use," said dentist David Perrott, medical director of the Salinas Valley Memorial Healthcare System in California who authored several research articles on the drug.

Propofol, marketed as Diprivan, contains fats that keep it stable so its potency doesn't diminish, said Robert Weber, executive director of pharmacy at University of Pittsburgh Medical Center.

"It actually looks like milk," said Weber. "The drug is very short-acting. When it's stopped, the effects go away right away and you wake up."

It is used for surgeries ranging from removing a cyst on a patient's hand to endoscopies. It keeps patients calm and sedated in intensive care units.

Oral surgeons are second only to anesthesiologists in their training to administer the drug because it is so widely used to remove wisdom teeth or insert dental implants, Perrott said.

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