Propofol: Acute toxicity

williamorange1

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Acute Toxicity



•Pathogenesis

Limited information is available on the acute toxicity of propofol in humans. The IV LD50 of propofol, administered as the emulsion formulation, averaged 53 and 42 mg/kg in mice and rats, respectively, while the oral LD50 of propofol, administered as a solution in soybean oil, was 1230 and 600 mg/kg in mice and rats, respectively.


•Manifestations

Overdosage of propofol would be expected to produce manifestations that principally are extensions of the drug’s pharmacologic and adverse effects. At least 2 fatalities have been reported following intentional self-administration of a 400- or 1600-mg dose of propofol. •Treatment

In the event of overdosage, therapy with propofol should be discontinued immediately, and appropriate symptomatic therapy initiated. Overdosage of propofol is likely to be associated with cardiorespiratory depression. If respiratory depression occurs, patients require administration of oxygen and institution of artificial ventilation. In addition, for cardiovascular depression, elevation of the lower extremities, increasing the rate of IV fluid administration, and/or use of vasopressors or anticholinergic agents are suggested.



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What does LD50 mean?

LD stands for "Lethal Dose". LD50 is the amount of a material, given all at once, which causes the death of 50% (one half) of a group of test animals. The LD50 is one way to measure the short-term poisoning potential (acute toxicity) of a material.

Toxicologists can use many kinds of animals but most often testing is done with rats and mice. It is usually expressed as the amount of chemical administered (e.g., milligrams) per 100 grams (for smaller animals) or per kilogram (for bigger test subjects) of the body weight of the test animal. The LD50 can be found for any route of entry or administration but dermal (applied to the skin) and oral (given by mouth) administration methods are the most common.
 
•Hepatic Effects

Abnormal liver function test results have been reported in adults receiving propofol for sedation in a critical care setting, but a causal relationship to the drug has not been established.
 
Bingo - that's the smoking gun - the amount of propofol found in MJs system totally contradicts what Murray stated.
 
Well, the autopsy already revealed that Murray administered more Propofol than he said he did. In other words, he lied.
 
one very important thing respiratory depression is an "adverse effect" of administring , the normal dose of propofol so in mj's body THEY DID FIND INDEED LETHAL AMOUNT OF PROPOFOL , NOT NORMAL DOSE that what "acute toxicity" means .
 
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what I mean i thought first that "acute toxicity" from propofol meant that propofol caused a respiratory depression which led to a carrdiac arrest regardless of the amount . but clearly here it means what happened was not just an " adverse effect" of administring propofol without monitoring . it was much more than that .
 
one very important thing respiratory depression is an "adverse effect" of administring , the normal dose of propofol so in mj's body THEY DID FIND INDEED LETHAL AMOUNT OF PROPOFOL , NOT NORMAL DOSE that what "acute intoxicity" means .


Not only respiratory depression but it also causes cardiovascular depression. It's already dangerous when administered in normal doses. When you associate lethal dose of proprofol with other sedatives you should not expect a good thing, specially if you're a doctor. Unless you're a reckless doctor...
 
I'm more convinced now that Murray did find mj in desperate need of help and instead of helping him he FINISHED him , no other explanation whatever for the "acute toxicity from propofol" , what happened started as an accident but Murray decided to kill mj instead of helping him
 
what I mean i thought first that "acute toxicity" from propofol meant that propofol caused a respiratory depression which led to a carrdiac arrest regardless of the amount . but clearly here it means what happened was not just an " adverse effect" of administring propofol without monitoring . it was much more than that .

You think Michael was assassinated?

I think treating insomnia with Propofol is bad enough, but there's also the fact that you can't administer if not at a hospital and without constant vigilance and monitoring machines.

Neglect is bad enough coming from a doctor.
 
no , it started as accident , mj suffered from a " adverse effect" of administering a normal dosage of propofol , but such an "adverse effect" would not caused MJ's death in a medical facility or if the medical equipment necessary were available at hand .

Murray knew he could't revive mj , and instead of calling for help immediately he decided to finish him and since propofol was not detected in normal autopsies the chances he would get away with what he did were huge . he decided to increase the dose which caused the " acute toxicity" because he was afraid if mj survived he might go to jail .
 
Ok, but one can argue that the mix of benzos, propfol, ativan, lorazepam, lidocane and all that other junk was deliberate.

No doctor would mix these all within the time frames that Murray said he gave Mj the drugs. Versed and propofol are used in combination in the operating room with all the monitors & 5 people standing over the patient.

So at least for me, there is no "recklessness" there - only a bumbling amateur would make those mistakes, and Murray was no amateur.


no , it started as accident , mj suffered from a " adverse effect" of administering a normal dosage of propofol , but such an "adverse effect" would not caused MJ's death in a medical facility or if the medical equipment necessary were available at hand .

Murray knew he could't revive mj , and instead of calling for help immediately he decided to finish him and since propofol was not detected in normal autopsies the chances he would get away with what he did were huge . he decided to increase the dose which caused the " acute toxicity" because he was afraid if mj survived he might go to jail .
 
"acute toxicity" means "acute toxicity" , no wonder the coroner ruled the death as homicide , injection by someone else.

mj could have died (like I previously thought) from an "adverse side " of administring propofol and since murray was not monitoring him properly we lost him , but after reading this article NO , Murray DID INJECT HIM WITH A LETHAL AMOUNT .it is as simple as that .


and do you realise how much RARE it is to die from "acute toxicity" from propofol ?
 
Hmmm, that's another theory worth looking into.

I'm more convinced now that Murray did find mj in desperate need of help and instead of helping him he FINISHED him , no other explanation whatever for the "acute toxicity from propofol" , what happened started as an accident but Murray decided to kill mj instead of helping him
 
no , it started as accident , mj suffered from a " adverse effect" of administering a normal dosage of propofol , but such an "adverse effect" would not caused MJ's death in a medical facility or if the medical equipment necessary were available at hand .

Murray knew he could't revive mj , and instead of calling for help immediately he decided to finish him and since propofol was not detected in normal autopsies the chances he would get away with what he did were huge . he decided to increase the dose which caused the " acute toxicity" because he was afraid if mj survived he might go to jail .

I've heard this theory before. And it makes a lot of sense and it makes me even more sick about this whole situation.

There's also a problem with the timelime. It seems that Murray left Michael alone for awhile. If so, he found Michael not breathing and did nothing about it (calling 911). Instead he called God knows who for over an hour or so.

Yeah, he had time to give him a big dose of propofol.
 
Acute toxicity = Heart & lungs stop working = MJ was killed.

heart&lungs stop working = simple and predicted "adverse effect" of administring a normal dose of propofol .

there is a huge difference between an "adverse effect" and "acute toxicity"

read carefully:


Overdosage of propofol would be expected to produce manifestations that principally are extensions of the drug’s pharmacologic and adverse effects

as for the benzo drugs , the lorazepam was the only contributing factor to the death . the other meds were only detected in mj's system but did not contribute.

also from all the drugs found beside mj's bed only lorazepam was found in mj's system .

clearly a staged overdose scene .

who to say murray did not inject mj with lethal amount of lorazepam also becuase it will be detectable in an autopsy .

he told the paramedics he gave mj only ONLY 2mg of lorazepam , he said the same to the doctors at UCLA. and they found an empty PILL bottle of lorazepam in mj's bathroom , clearly he was trying to convince them that mj went and took the pilld himslef .


Murray killed mj . and he killed him in a very cruel and cold way
 
I don't understand the point you are trying to make?

The adverse effects of propofol are known. That's why you are not supposed to administer propofol in an unmonitored setting. You have to be able to protect the patient's airway in the event he/she develops respiratory depression. However, the dose needed to develop 'acute toxicity' is variable. Even a "normal" dose can produce such adverse effects. In practice, this drug is goofy.

These words sound incriminating, but every single drug known to man has adverse effects. I don't think any of this proves what this guy's intentions were. This may have been a horrible mistake.

Also, 2mg of lorazepam is not a huge dose.
 
I'll post here what I posted before at that crap kop discussion board :

also in response to a previous question by elusive :

from the search warrants


" a search of the residence , specifically JACKSON's bedside revealed numerous bottles of medications prescribed by Dr.MURRAY to JACKSON , including Diazepam(valium) ,temasulosin(flomax),Lorazepam (ativan) and temazepam(restoril)" noticed from all the drugs found in MJ's system only LORAZEPAM was found beside his bed or in his bathroom , it goes with what Midas posted above , Murray told them he gave him lorazepam only and from the drugs he gave mj only lorazepam was found BESIDE HIS BED.


those drugs above are mentioned in the search warrant issued to raid MUrray's office in vegas , it is a different one from the search warrant issued to search MJ's resident which was issued 26th of june . so the detectives based the seeking for a search warrant to murray's office on drugs they found on 25th of June and not the "tainted ones" who won't be admissible in court .



another important part :


Murray told them his "doctor bag was still at the residence" and told them where to find it on 27th of june , in other words they searched MJ residence two times one at 25th and another at 26th and in both times they did not recover the bag means he was HIDING IT , he did not intend to make it visible or to admit to what he did first .

" recovered multiple bottles/vials of Lidocaine, several bottles/vials of propofol (diprovan), bottles/vials of lorazepam (ativan), bottles /vials of Midazolam(versed) and bottles /vials of flumazenil . None of these items were labeled as prescribed to any patient ".

see all the meds in mj's body were hidden first but lorazepam.
 
Aside: Finally, a medical expert admits Michael Jackson was not addicted to Propofol.
Read Below:
Authorities Taking Their Time in Jackson Case
(Yahoo news, (9/21/09)
Dr. Jayson Hymes, an anesthesiologist and specialist in pain medication and addiction, said authorities are confronted with a central question:
“It’s not illegal to be a bad doctor but when does it go from bad medicine to so unbelievably stupid it’s criminal negligence?”

He said investigators may be questioning Murray’s claim that he was trying to “wean” Jackson off the powerful anesthetic
by giving him decreasing doses.“It makes no sense,” said Hymes. “You don’t wean people off propofol. People don’t go around craving propofol. What he needed to be weaned off of were all the other drugs.”
To Read the Entire Article Click on the Link Below:

http://news.yahoo.com/s/ap/20090921/ap_en_...XV0aG9yaXRpZXN0[/url]
 
I don't understand the point you are trying to make?

The adverse effects of propofol are known. That's why you are not supposed to administer propofol in an unmonitored setting. You have to be able to protect the patient's airway in the event he/she develops respiratory depression. However, the dose needed to develop 'acute toxicity' is variable. Even a "normal" dose can produce such adverse effects. In practice, this drug is goofy.

These words sound incriminating, but every single drug known to man has adverse effects. I don't think any of this proves what this guy's intentions were. This may have been a horrible mistake.

Also, 2mg of lorazepam is not a huge dose.

sorry I can't explain it any more , I mean he was injected with much more than normal dose for the coroner to determine it was an "acute"

it is pretty normal to suffer from "adverse effects" such as respiratory depression that's why the equipment are always available to help you but it is not normal at all to suffer from "acute propofol toxicity" that's why the infomration is limited on it in human .

as for lorazepma, ofcourse 2mg of lorazepam are NOTHING and that's another lie by him . he injected him with more much more than that .
 
"Because the commercially available formulations of propofol are 1% oil-in-water emulsions, patients receiving IV infusions of the drug for longer than 3 days tend to have increased serum lipid concentrations (e.g., triglycerides), while IV propofol infusions administered for 7 days or longer may result in serum triglyceride concentrations 3–4 times the normal values. "


In the human body, high levels of triglycerides in the bloodstream have been linked to atherosclerosis, and, by extension, the risk of heart disease and stroke. However, the relative negative impact of raised levels of triglycerides compared to that of LDL:HDL ratios is as yet unknown. The risk can be partly accounted for by a strong inverse relationship between triglyceride level and HDL-cholesterol level.

Another disease caused by high triglycerides is pancreatitis



comes to mind healthy heart, kidneys and the other organs .
 
comes to mind also 6 weeks he was giving him that shit, also comes to mind his attorney saying only on occassion he stayed at Mj's mansion and he spent most of his time at his girlfriend's apartment. but also comes to mind " i wanted to wean him off his addiction to propofol" so many lies murray !!!
 
Didnt Micheal went to slepp with Ativan and valium on some nights? Propofol will supress respiration and then that will affect the Oxygen to the Brain and Heart. That is why you die if not monitored. Murray did not monitor Michael as should be done in the hospital.
 
I don't understand the point you are trying to make?

The adverse effects of propofol are known. That's why you are not supposed to administer propofol in an unmonitored setting. You have to be able to protect the patient's airway in the event he/she develops respiratory depression. However, the dose needed to develop 'acute toxicity' is variable. Even a "normal" dose can produce such adverse effects. In practice, this drug is goofy.

These words sound incriminating, but every single drug known to man has adverse effects. I don't think any of this proves what this guy's intentions were. This may have been a horrible mistake.

Also, 2mg of lorazepam is not a huge dose.

Agree completely. You don't need to overdose to get someone to stop breathing from Propofol, that's exactly the reason why it should NOT be used in a home setting without the right equipment and enough STAFF around to help if something happens. Also, even for two people with the exact same weight you might need a different dose of Propofol...one may need less, the other one may need a little more.

I never believed the "I gave him 25 mg of Propofol" statement from Murray. 25 mg is nothing to a person of MJ's size. What is problematic though is that Murray left Michael alone. No matter WHAT dose he gave, the reckless and WRONG thing he did was to leave Michael alone and also that he did not have a trained nurse or a doctor there to help him. And I'm not even gonna get into all the other THOUSANDS of things he did wrong, beginning from failing to call 911 to wrong kind of CPR. What I am dying to know is if he intubated Michael? I'd love to know how he tried to get him to breathe? There is no way he can get away from all of this. And there is no way he should be allowed to practise medicine after this.
 
Agree completely. You don't need to overdose to get someone to stop breathing from Propofol, that's exactly the reason why it should NOT be used in a home setting without the right equipment and enough STAFF around to help if something happens. Also, even for two people with the exact same weight you might need a different dose of Propofol...one may need less, the other one may need a little more.

I never believed the "I gave him 25 mg of Propofol" statement from Murray. 25 mg is nothing to a person of MJ's size. What is problematic though is that Murray left Michael alone. No matter WHAT dose he gave, the reckless and WRONG thing he did was to leave Michael alone and also that he did not have a trained nurse or a doctor there to help him. And I'm not even gonna get into all the other THOUSANDS of things he did wrong, beginning from failing to call 911 to wrong kind of CPR. What I am dying to know is if he intubated Michael? I'd love to know how he tried to get him to breathe? There is no way he can get away from all of this. And there is no way he should be allowed to practise medicine after this.

and I agree with you. haha :)

the truth is, he could have told the truth about only giving 25 mg propofol and the same result could have happened. You just never know with this drug. I'm not saying he's telling the truth, but I think it is completely possible that:

1) Michael had been given propofol for sleep many times (he should NOT have, but this is very possible)
2) Every single previous time, nothing bad happened
3) murray was irresponsible (WITHOUT having malicious intent) and felt comfortable leaving the room given his prior experience with giving propofol to Michael

This is entirely possible and would mean that this was all a terrible, irresponsible mistake.

After he realized what happened, it may have already been too late to save Michael, and all his subsequent mistakes (i.e. not calling 911 immediately) may not have mattered anyway. It's very plausible that he panicked and realized that this was 100% his fault, and made bad choices.

But bottom line for me is, none of this changes the loss I feel inside. I would like to give this man the same right to a fair trial as we all begged for Michael to have. I know Michael would want the same. He was never a vindictive, angry person. I don't have any proof that this was more than a mistake, and until he's proven guilty of that, he should be punished accordingly (mistake or not, he violated the oath he swore to: First Do No Harm).

Reading into all these adverse effects like elevated triglycerides, etc is reading too much into this *in my opinion*. Elevated lipids take decades to cause stroke, heart attack, etc.
 
Thank you all for very informative posts! Here's what I don't get though: if the scene was set up to look like accidental overdose and the propofol was never supposed to be found, why in the world did Murray admit to using it? Why tell the police where he was storing his drugs? (Maybe he just didn't know if the police had already found it or not and thought it's better to admit? But then, if he had so much time to manipulate the scene, why didn't he just get rid of it? Questions, questions, questions ... :( )
 
because there were marks all over MJ's body , needles markds and since MURRAY was a home doctor he could not deny he at least saw the marks, also there were witnesses to the oxygen tanks and sooner or later someone would talk about MJ asking for propofol which indeed happened Lee came with the story 4 days after mj died .

after he went to see his lawyer and they discussed the whole situation , his lawyer would have told him you better admit you gave the propofol yourself instead of denying it first and then they discover you were administring it .now they are claiming we collaborated with the police , although in the search warrant the police officer said Murray was not trustful with what he told the paramedics and the UCLA doctors and then the phone calls .
It is a damage control strategy
 
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he told the detectives he gave MJ 2mg of Flumanezil (Anexate ) to revive him , from the list of drugs in mj's system , no such drug was found in MJ's body , another indication murray did not try to revive him at all .


why was he lying even after he admitted he gave him propofol ?
 
I've heard this theory before. And it makes a lot of sense and it makes me even more sick about this whole situation.

There's also a problem with the timelime. It seems that Murray left Michael alone for awhile. If so, he found Michael not breathing and did nothing about it (calling 911). Instead he called God knows who for over an hour or so.

Yeah, he had time to give him a big dose of propofol.


Exactly!!! And if propofol has a half life of 30-60 min. (according to wikipedia), that's why he took so long to call 911, he thought he would get away with it.
 
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