Medication Guide App

Etomidate

Pronunciation

Pronunciation: e-TOM-i-date
Class: General anesthetic

Trade Names

Amidate
- Injection, solution 2 mg/mL

Pharmacology

Etomidate is an anesthetic without analgesic activity.

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Pharmacokinetics

Metabolism

Rapidly metabolized in the liver, primarily by hydrolysis.

Elimination

Elimination half-life about 75 min. Approximately 75% eliminated in the urine within 24 h.

Onset

Usually within 1 min.

Duration

3 to 5 min.

Special Populations

Renal Function Impairment

Appears to have no effect on etomidate pharmacokinetics.

Hepatic Function Impairment

Vd increases 2-fold in patients with cirrhosis compared with healthy subjects.

Elderly

Vd, total Cl, and plasma protein binding are decreased in elderly patients.

Indications and Usage

Induction of general anesthesia; supplementation of subpotent anesthetic agents (eg, nitrous oxide) during maintenance of anesthesia for short operative procedures.

Contraindications

Standard considerations.

Dosage and Administration

Adults and Children 10 yr of age and older

IV The dose must be individualized in each case. The dose varies between 0.2 and 0.6 mg/kg (usual dose, 0.3 mg/kg) injected over a period of 30 to 60 sec. Elderly patients may require reduced doses.

General Advice

  • Etomidate is compatible with commonly administered preanesthetic medications.
  • Not intended for prolonged infusion.
  • Do not administer unless the solution is clear and the container is undamaged.
  • Discard unused portion.

Storage/Stability

Store at 59° to 86°F.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Transient venous pain (20%); arrhythmias; bradycardia; hypertension; hypotension; tachycardia.

GI

Postoperative nausea and/or vomiting.

Musculoskeletal

Transient skeletal muscle movements, including myoclonic, averting, tonic, and eye movements (32%).

Respiratory

Apnea of 5- to 90-sec duration; hiccup; hyperventilation; hypoventilation; laryngospasm; snoring.

Miscellaneous

Anaphylaxis.

Precautions

Monitor

Monitor renal function in elderly patients. Monitor plasma cortisol and aldosterone levels during induction.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established in children younger than 10 yr of age.

Elderly

May induce cardiac depression in elderly patients, especially in patients with hypertension. Because renal function may be reduced in elderly patients, select dose with caution.

Renal Function

Because etomidate is excreted primarily by the kidney, the risk of toxicity may be increased in patients with renal function impairment.

Overdosage

Symptoms

Administering an injection too rapidly may result in a fall in BP. No CV or respiratory effects have been attributed to an overdosage.

Copyright © 2009 Wolters Kluwer Health.

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