Dmytriiev D. Clinico-pharmacological interaction of propofol and analgetic with modificators of microsomal monooxygenaz (clinical-experimental research)

The dissertation is dedicated to research of clinic-pharmacological interaction of propofol with analgesics and modificators of microsomal monooxygenases. Proved, that continuous introduction of propofol results into development of “propofol infusion syndrom”, which is declared with disorders of lipid metabolism, lesion of liver and disorders of functions of the pancreas and morphological changes in liver. Early predictors of threat of occurrence of “propofol infusion syndrom” at children are female gender, age of patients (3-7 years), simultaneous usage with opioid analgesics and inhibitors of cytochrome P450 (norphloxacin і pentoxiphillin). Premedication with ketorolac reduces undesirable effects of propofol, but tramadol and butorfanol increases negative influences and strongly inhibits excretion of metabolites of propofol at rats. Combined usage of propfol (10 mg/kg) with ketorolac and diclofenac sodium strongly increases analgesic effect of nonsteroid anti-inflammatory drugs and slow down excretion of diclofensc sodium on 120-480 m. At children is most effective to administrate ketorolac and diclofenac fo premedication, which are not increasing undesirable manifestations of propofol. It is necessary to avoid usage of tramadol and butorfanol and inhibitors of cytochrome P450.