Etomidate

Indications

Etomidate is used for: Anaesthesia

Adult Dose

General Anesthesia Induction 0.3-0.6 mg/kg IVP over 30-60 sec

Child Dose

General Anesthesia Induction <10 years: Safety and efficacy not established >10 years: 0.3-0.6 mg/kg IVP over 30-60 sec

Renal Dose

Administration

IV Administration Inject undiluted by direct IV injection over 30-60 sec; do not administer by prolonged IV infusion Inject into large forearm vein

Contra Indications

Hypersensitivity. Reduced or at risk of reduced adrenocortical function. Porphyria.

Precautions

Opioid analgesics or benzodiazepines may be given as premedications to reduce risk of convulsions. Not to be admin by prolonged infusion. Pre-existing epilepsy. Elderly and child <10 yrs. Pregnancy and lactation. Lactation: Not known if excreted in breast milk; use caution

Pregnancy-Lactation

Pregnancy category: C Lactation: Not known if excreted in breast milk; use caution

Interactions

Antipsychotics, sedatives or opioids; calcium-channel blockers.

Adverse Effects

Side effects of Etomidate : >10% Transient injection site pain (30-80%), Skeletal muscle movements, mainly myoclonic (32%), Opsoclonus (20%), Adrenal suppression 1-10% Hiccups <1% Apnea (duration: 5-90 seconds), Arrhythmias, Hyperventilation, HTN, Hypotension, Hypoventilation, Laryngospasm, Nausea/vomiting, Oxygen desaturation, Snoring (may be associated with partial upper airway obstruction)

Mechanism of Action

Etomidate is a carboxylated imidazole. It is a sedative and hypnotic agent used commonly for induction anaesthesia.