Incidence of Adverse Drug Reactions Related to Propofol in an Intensive Care Setting

Objective. The purpose is to monitor mechanically ventilated patients on propofol for signs and symptoms of adverse drug effects (ADE). Secondary objectives include: comparison of the incidence of hypertriglyceridemia, evaluation of the appropriate use of propofol, and assessment of the impact of a clinical pharmacist. Methods. A daily report was generated profiling propofol patients during a three month period. An IRB approved data collection tool gathered patient demographic information . Rate/dose and duration of propofol was also collected. If an ADE was discovered, the physician was notified and information regarding the ADE was also collected. Acceptance of pharmacy interventions were evaluated. Data were summarized and at study completion inferential statistics will be used to compare data. Results. At study midpoint (n=15), there were 66% male patients averaging 50.7 years (25-75 years). Propofol therapy averaged 5.37 days with 3.17 mg/kg/min (31.7 mcg/kg/min)average dose . In 20% of the subjects, the physician ordered a triglyceride level `appropriately, whereas the primary investigator ordered a triglyceride level in 47% of the patients. The average triglyceride level was 168.9mg/dl (77- 296mg/dL). Co-morbid diseases included hyperlipidemia, hypertension, coronary artery disease, and heart failure. One subject was HIV positive on a protease inhibitor. Three subjects were also receiving TPN, with one subject being administered TPN with lipids. Thirty-three subjects were receiving a HMGCOA Inhibitor. Conclusion. No ADEs have been identified this far, however education of monitoring triglycerides has been addressed with prescribing physicians. Subject selection and data analysis is still ongoing at this time.