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What the Heck is Propofol? More Info On the Drug That May Have Killed Michael Jackson
Newsweek
by Kate Dailey and Rebecca Shabad
The King of Pop’s death has been under investigation for more than a month, and definite answers have yet to emerge. While the final toxicology report is expected to be released next week, propofol—brand name Diprivan—is being named as a potential culprit in Michael Jackson’s death. Detectives found a large quantity of it in his home, and his personal physician allegedly admitted administering the drug to Jackson on the day the singer passed away at age 50. While celebrity deaths by drug overdose are nothing new, the usual culprits are familiar names like cocaine, morphine, and heroin. So what is propofol, exactly?
“Propofol is a medication that was invented 20 to 25 years ago for anesthesia. It’s what we call a sedative hypnotic. It puts you to sleep; it makes you forget things,” says Dr. David Kloth, past president of American Society of Interventionism Pain Physicians and current president of Connecticut Pain Society. It's used in the emergency room and during surgery for sedation. The drug is an ideal for anesthesia because it works quickly and leaves very little lingering effects when used correctly. “It comes on very quickly; it also wears off very quickly. If someone’s on a continuous drip, and you turn it off, in five or 10 minutes, they’re wide awake,” says Kloth.
Jackson, who reportedly suffered from debilitating insomnia, may have been seeking a little shut eye with the aid of this drug. What makes his death more tragic is that propofol wouldn’t have helped his exhaustion. “It does not cause stage 4 REM sleep,” Kloth says. “Michael Jackson was unfortunately either misinformed or misunderstood ... He would actually wake unrested, because the brain did not enter the appropriate stage of sleep.”
The fact that the drug was administered outside a hospital or health-care facility is “mind-boggling,” says Dr. Kenneth Elmassian, a cardiac anesthesiologist at Michigan Regional Medical Center. “You can’t go to a pharmacist, hand a prescription over and get the drug,” he says. At the same time, he adds that any licensed physician can give the medication—though the American Society of Anesthesiologists (of which he is a board member), doesn’t recommend that doctors not trained in anesthesiology do so, because the drug is extremely dangerous.
Part of what makes the drug so dangerous is it’s extreme variability. “There are certain prescribeable doses, but the reality is what a certain dose for one person may not be the certain dose that’s going to be safe for another person,” says Elmassian. A number of factors─including age, weight, hydration─factor into the efficacy of the drug, and too much can lead to a drop in blood pressure and trouble breathing. Enough can be fatal.
Propofol is also extremely addictive. “It actually lights up in the addiction center in the same place that alcohol and morphine and even nicotine [do],” says Kloth. However, he adds that the benefit to addicts are few. “People abuse drugs to get high on them, [but] you don’t even enjoy the high. You wake up and say, ‘Oh, shoot I missed it.' ”
When administered properly and infrequently, the drug’s risks decrease. “Having it one time for surgery is not going to get anybody addicted,” says Kloth. “Once you wake up in the recovery room, it’s gone. It has no bearing on your respiratory depression. If given properly, this drug is extraordinarily safe—it’s one of the safest drugs we have.”
Not, however, for Jackson. “My prediction is that Michael Jackson will be deemed a polysubstance overdose,” says Kloth. “It is probably possible and probably likely that he took other medications that evening.”
The consequences for the doctor who provided Jackson with the drug are dire. According to The Associated Press, Dr. Conrad Murray allegedly admitted to police that he set Jackson up with the IV, and Kloth thinks charges of manslaughter are not inappropriate if it turns out Jackson was improperly supervised while on profonol.
"You have given him the bullet, which he shot himself with," Kloth says. "You gave him the loaded gun and said: pull the trigger.”
http://blog.newsweek.com/blogs/theh...rug-that-may-have-killed-michael-jackson.aspx
What the Heck is Propofol? More Info On the Drug That May Have Killed Michael Jackson
Newsweek
by Kate Dailey and Rebecca Shabad
The King of Pop’s death has been under investigation for more than a month, and definite answers have yet to emerge. While the final toxicology report is expected to be released next week, propofol—brand name Diprivan—is being named as a potential culprit in Michael Jackson’s death. Detectives found a large quantity of it in his home, and his personal physician allegedly admitted administering the drug to Jackson on the day the singer passed away at age 50. While celebrity deaths by drug overdose are nothing new, the usual culprits are familiar names like cocaine, morphine, and heroin. So what is propofol, exactly?
“Propofol is a medication that was invented 20 to 25 years ago for anesthesia. It’s what we call a sedative hypnotic. It puts you to sleep; it makes you forget things,” says Dr. David Kloth, past president of American Society of Interventionism Pain Physicians and current president of Connecticut Pain Society. It's used in the emergency room and during surgery for sedation. The drug is an ideal for anesthesia because it works quickly and leaves very little lingering effects when used correctly. “It comes on very quickly; it also wears off very quickly. If someone’s on a continuous drip, and you turn it off, in five or 10 minutes, they’re wide awake,” says Kloth.
Jackson, who reportedly suffered from debilitating insomnia, may have been seeking a little shut eye with the aid of this drug. What makes his death more tragic is that propofol wouldn’t have helped his exhaustion. “It does not cause stage 4 REM sleep,” Kloth says. “Michael Jackson was unfortunately either misinformed or misunderstood ... He would actually wake unrested, because the brain did not enter the appropriate stage of sleep.”
The fact that the drug was administered outside a hospital or health-care facility is “mind-boggling,” says Dr. Kenneth Elmassian, a cardiac anesthesiologist at Michigan Regional Medical Center. “You can’t go to a pharmacist, hand a prescription over and get the drug,” he says. At the same time, he adds that any licensed physician can give the medication—though the American Society of Anesthesiologists (of which he is a board member), doesn’t recommend that doctors not trained in anesthesiology do so, because the drug is extremely dangerous.
Part of what makes the drug so dangerous is it’s extreme variability. “There are certain prescribeable doses, but the reality is what a certain dose for one person may not be the certain dose that’s going to be safe for another person,” says Elmassian. A number of factors─including age, weight, hydration─factor into the efficacy of the drug, and too much can lead to a drop in blood pressure and trouble breathing. Enough can be fatal.
Propofol is also extremely addictive. “It actually lights up in the addiction center in the same place that alcohol and morphine and even nicotine [do],” says Kloth. However, he adds that the benefit to addicts are few. “People abuse drugs to get high on them, [but] you don’t even enjoy the high. You wake up and say, ‘Oh, shoot I missed it.' ”
When administered properly and infrequently, the drug’s risks decrease. “Having it one time for surgery is not going to get anybody addicted,” says Kloth. “Once you wake up in the recovery room, it’s gone. It has no bearing on your respiratory depression. If given properly, this drug is extraordinarily safe—it’s one of the safest drugs we have.”
Not, however, for Jackson. “My prediction is that Michael Jackson will be deemed a polysubstance overdose,” says Kloth. “It is probably possible and probably likely that he took other medications that evening.”
The consequences for the doctor who provided Jackson with the drug are dire. According to The Associated Press, Dr. Conrad Murray allegedly admitted to police that he set Jackson up with the IV, and Kloth thinks charges of manslaughter are not inappropriate if it turns out Jackson was improperly supervised while on profonol.
"You have given him the bullet, which he shot himself with," Kloth says. "You gave him the loaded gun and said: pull the trigger.”
http://blog.newsweek.com/blogs/theh...rug-that-may-have-killed-michael-jackson.aspx
