Ufol Emulsion For IV Infusion

✔️ How does Ufol work?

Propofol, the active ingredient in Ufol, is a sedative-hypnotic used for anesthesia induction and maintenance. When injected intravenously, it rapidly induces unconsciousness (typically within 40 seconds). Its mechanism of action involves enhancing the inhibitory effects of gamma-aminobutyric acid (GABA) through GABA-A receptors.

✔️ Dosage & Administration: Ufol

For Adults:

Induction of Anesthesia:

• The dosage is individualized based on patient response.
• Standard initial dose: 40 mg (4 mL) via slow IV bolus at 10-second intervals until anesthesia onset.
• Healthy adults under 55 years: 2.2-2.5 mg/kg
• Elderly patients: 1.0-1.5 mg/kg
• Patients in ASA grades 3 & 4: Lower doses, usually 20 mg (2 mL) every 10 seconds

Maintenance of Anesthesia:

Can be achieved through continuous infusion or repeated bolus injections.

Continuous Infusion:

• Initially, some patients may require 8-10 mg/kg/h for the first 10-20 minutes.
• Maintenance dosage typically ranges from 4-6 mg/kg/h (up to 12 mg/kg/h).
• Administer 25-50 mg (2.5-5.0 mL) as needed.

Sedation in Intensive Care:

• Initial bolus: 1.0-2.0 mg/kg
• Continuous infusion: 0.3-4 mg/kg/h based on sedation needs

Sedation for Surgery/Diagnostics:

• Initial dose: 0.5-1 mg/kg over 1-5 minutes
• Maintenance infusion: 1-4.5 mg/kg/h
• Additional bolus: 10-20 mg if deeper sedation is required
• Lower doses are recommended for elderly patients or those in ASA grades 3 & 4

For Children:

General Anesthesia (Induction & Maintenance):

• Not recommended for children under 3 years due to lack of safety data.
• Children over 8 years: 2.5 mg/kg via slow IV injection.
• Younger children may require slightly higher doses per kg.
• ASA grades 3 & 4 require reduced doses.
• Maintenance infusion: 9-15 mg/kg/h.

Sedation in Intensive Care/Surgical Procedures:

• Not recommended for children, as safety has not been established.
• Serious adverse effects, including fatalities, have been reported in cases where the drug was used against recommendations, particularly in children with respiratory infections

Not recommended for children under 3 years.

✔️ Side Effects

Local Reactions:

• Generally well-tolerated; the most common issue is injection site pain, which can be minimized by using lidocaine or injecting into larger veins.
• Rare cases of thrombosis and phlebitis.

General Effects:

• Hypotension and temporary apnea may occur, especially in critically ill patients.
• Rare cases of epileptic-like movements, convulsions, dystonia, and pulmonary edema.
• Some patients may experience headaches, nausea, or vomiting upon recovery.
• Hypersensitivity reactions, including anaphylaxis, hypotension, bronchospasm, edema, and facial erythema, have been reported.
• Cardiac arrest has occurred in some cases.
• Prolonged use may cause green or reddish-brown urine due to harmless metabolites.
• In rare cases, altered sexual behavior post-anesthesia.

✔️

Method of Administration

• To minimize injection pain, Ufol may be mixed with lidocaine (10 mg/mL) in a 1:20 ratio immediately before injection.
• Can be administered undiluted or diluted for infusion.
• Inspect ampoules or vials for irregularities before use.
• For infusion, use volumetric or syringe pumps to prevent accidental overdose.

Dilution:

• Can be diluted only with 5% dextrose infusion.
• Maximum dilution: 1 in 5 (2 mg/mL concentration).
• Must be prepared in a PVC infusion bag or glass bottle using aseptic techniques.
• Use diluted solution within 6 hours; discard any remaining solution.

✔️ Overdose Management

• Overdose may lead to cardiorespiratory depression.
• Treatment:
  • Respiratory support: Provide artificial ventilation with oxygen.
  • Cardiovascular support: Lower the patient’s head and elevate their legs.
  • Medication support: Administer pressor agents, plasma expanders, or Ringer-type electrolyte solutions if needed.

✔️ Drug Interactions

• Compatible with spinal and epidural anesthesia, premedications, muscle relaxants, inhalation anesthetics, and analgesics.
• No known pharmacological incompatibility.
• Lower doses may be sufficient when combined with local anesthetics.
• Does not inhibit adrenocortical hormone synthesis.
• Opioids may enhance Ufol-induced respiratory depression.

✔️ Contraindications

• Patients allergic to propofol or any of its ingredients.

✔️ Pregnancy & Lactation

• Not recommended during pregnancy due to insufficient safety data.
• Rapidly crosses the placenta, making it unsuitable for obstetric anesthesia.
• Safety in breastfeeding mothers has not been established.

✔️ Precautions & Warnings

• Should be administered only by anesthesiology specialists or under their supervision.
• The doctor performing a procedure should not administer Ufol simultaneously.
• Continuous monitoring is required to detect early signs of hypotension, airway obstruction, hypoventilation, or insufficient oxygen intake.
• Special caution is needed for non-ventilated sedated patients.
• Use with caution in patients with:
  • Cardiac, respiratory, renal, or hepatic impairment
  • Hypovolemia or poor overall health
  • High vagal tone (risk of bradycardia/asystole) – consider administering an anticholinergic
  • Lipid metabolism disorders (monitor lipid levels)
  • Epilepsy (risk of convulsions)
• Ufol does not provide pain relief; analgesics should be used as needed.
• Patients should be fully recovered before discharge, as anesthesia may temporarily impair cognitive function.

✔️ Reconstitution & Storage

• Should not be mixed with any solutions except 5% dextrose or 10 mg/mL lidocaine injection.
• Store below 25°C; do not freeze.
• Discard any unused solution.