Reduces CBF, CMRO2 and ICP Maintains or increases CPP Lowers seizure threshold
Pharmacokinetics
75% protein bound Highly lipid soluble High volume of distribution, three compartment model Hepatic metabolism Renal excretion (some bile) Short context sensitive (4.8 h)
Advantages
Rapid onset of action as induction agent Only lasts 3–5 minutes after single bolus Favourable effects on CBF, CMRO2 and ICP
Disadvantages and major side effects
Adrenal suppression Metabolic acidosis from propylene glycol vehicle Pain on injection Myoclonic movements Nausea and vomiting
Dosage
Induction: 0.2–0.4 mg/kg
Other significant facts
Originally developed as an anti-fungal agent
Appropriate uses in TBI
Induction of anaesthesia, with caution regarding adrenal suppression
