by James J. Galligan, Ph.D., Associate Chair,
Department of Pharmacology and Toxicology

Propofol Structure

Propofol Structure

Diprivan (propofol) is in the news as being a potential contributor to the death of Michael Jackson. What is propofol?

Propofol is a short acting anesthetic drug that is most commonly used in relatively simple outpatient surgical procedures.For example, if you are over 50 years old and have a routine colon cancer screening colonoscopy, propofol would most likely have been the anesthetic you received. The advantages of this drug is that it has a rapid onset of action (less than 1 minute) and its effects are short lived (20 minutes). This makes it ideal for use for the kind of procedures described above.

Propofol is a relatively safe drug when it is used for appropriate purposes and when it is administered by trained medical personnel. The problems arise when the drug is abused. Propofol acts on the nervous system in ways that are similar to other anesthetic and sedative drugs like diazepam (Valium) and barbiturates. All of these drugs inhibit the function of nerve cells in the brain by interacting with receptors for the neurotransmitter GABA. These drugs can inhibit the nerve cells that make you anxious and that is why they are used to reduce stress. However, they also inhibit the nerve cells that control your heart and breathing. Too much of these drugs can cause a person’s heart to stop beating, or they can stop breathing.

Valium and barbiturates are available in orally administered forms (pills) and this makes it harder to overdose (although overdoses happen all the time). However, propofol can only be administered intravenously; there are no propofol pills. This is where the danger arises. When drugs are administered directly into the blood stream there is little margin for error with the dose. Just a little too much can be fatal and if there are no trained medical personnel nearby (as normally occurs with a drug abuser) there is no one to administer life support procedures.

It is not clear at this time if propofol contributed to Michael Jackson’s death. But if he was using this drug in a setting where trained medical personnel were not involved, he was certainly putting himself at great risk.