IUPAC_name = ethyl 3- [(1"R")-1-phenylethyl] imidazole-
CAS_number = 33125-97-2
ATC_prefix = N01
ATC_suffix = AX07
PubChem = 667484
DrugBank = APRD00965
C = 14 |H = 16 |N = 2 |O = 2
molecular_weight = 244.289 g/mol
protein_bound = 75%
elimination_half-life = 75 min
excretion = Renal (85%) and biliary (15%)
pregnancy_category = D (U.S.)
legal_UK = POM
routes_of_administration = Intravenous
Etomidate is a short acting
intravenousanaesthetic agent used for the induction of general anaesthesiaand for sedationfor short procedures such as reduction of dislocated joints and cardioversion. It was discovered at Janssen Pharmaceuticain 1964.
Etomidate is commonly used in the emergency setting as part of a
rapid sequence inductionto induce anesthesia or for conscious sedation. It is often used in this setting since it has a rapid onset of action and a low cardiovascular risk profile, and therefore is less likely to cause a significant drop in blood pressure than other induction agents.
In the operating room with a stable patient, anesthesia providers may choose an alternative induction agent, such as
propofol, thiopentalor methohexital. (see Side effects below).
At the typical dose, anesthesia is induced for about 5–10 minutes even though the half-life of drug metabolism is approximately 75 minutes. This is because etomidate is redistributed from the plasma to other tissues.
The anaesthetic induction dose for adult humans is 0.3 mg/kg intravenously, with a typical dose ranging from 20-40 mg. In common with all induction agents, etomidate causes loss of consciousness after one arm-brain circulation time. In very brief procedures such as cardioversion, a 10 mg dose may be used which may be repeated for effect.
DOSING: ADULTS — Anesthesia: I.V.: Initial: 0.2-0.6 mg/kg over 30-60 seconds for induction of anesthesia; maintenance: 5-20 mcg/kg/minute
Etomidate is highly protein bound in
blood plasmaand is metabolised by hepatic and plasma esterases to inactive products. It exhibits a bi-exponential decline, with a redistribution half-lifeof 2–5 minutes and an elimination half-life of 68–75 minutes.
The use of etomidate infusions for
sedationof critically ill patients in intensive care units has been associated with increased mortality, which is due to suppression of steroidsynthesis (both glucocorticoids and mineralocorticoids) in the adrenal cortex. Thus, etomidate contributes to critical illness–related corticosteroid insufficiency. This effect has been demonstrated after a single dose, and lasts about 24 hours. There is no evidence that a single induction dose of etomidate has any effect on morbidity or mortality. However, some sources advise giving a prophylactic dose of steroids (e.g. hydrocortisone) if etomidate is used.
Seizure-like activity is occasionally seen with anesthetic induction. In the absence of concurrent EEG monitoring, it is difficult to ascribe this to cortical activity.
Myoclonicmovement originating at the spinal cord level is often a likely mechanism. Excitatory phenomena, and epileptiform movements and EEGactivity may be observed during induction. Etomidate consistently increases the amplitude of somatosensory evoked potentials(in contrast to most anaesthetic agents).
Etomidate in the propylene glycol formulation may produce pain on injection, a side effect which is less likely with the lipid formulation.
There is a 30-fold difference between the
effective doseand the lethal doseof etomidate, making it an extremely safe agent.
Post operative vomiting is more common than with other induction agents.
Etomidate is usually presented as a clear colourless solution for injection containing 2 mg/ml of etomidate in an aqueous solution of 35%
propylene glycol, although a lipid emulsionpreparation (of equivalent strength) has also been introduced. Etomidate is presented as a racemicmixture, but only the D- isomerhas pharmacological activity.
Pharmacodynamics / Kinetics
Onset of action: 30-60 seconds
Peak effect: 1 minute
Duration: 3-5 minutes; terminated by redistribution
Distribution: Vd: 2-4.5 L/kg
Protein binding: 76%;
Metabolism: Hepatic and plasma esterases
Half-life elimination: Terminal: 2.6 hours
Wikimedia Foundation. 2010.
Look at other dictionaries:
Etomidate — Étomidate Étomidate Général Nom IUPAC … Wikipédia en Français
Étomidate — Général Nom IUPAC … Wikipédia en Français
Etomidate — Strukturformel Allgemeines Freiname Etomidat Andere Namen (+) Ethyl 3 … Deutsch Wikipedia
Etomidate — ЭТОМИДАТ ( Еtоmidate )*. Этиловый эфир 1 (n фенил этил) 1H имидазол 5 карбоновой кислоты. Синонимы: Гипномидат,Раденаркон, Radenarcon, Amidate, Hypnomidate и др. Средство для кратковременной внутривенной анастезии. Доза 0,2 0,3 мг/кг оказывает… … Словарь медицинских препаратов
etomidate — noun A short acting intravenous anaesthetic, ethyl 3 [(1R) 1 phenylethyl]imidazole 4 carboxylate … Wiktionary
etomidate — A potent intravenous hypnotic used in anesthesia. * * * etom·i·date (ə tomґĭ dāt) a short acting sedative hypnotic, administered intravenously for the induction and maintenance of general anesthesia and as a supplement to low… … Medical dictionary
33125-97-2 — Étomidate Étomidate Général Nom IUPAC … Wikipédia en Français
C14H16N2O2 — Étomidate Étomidate Général Nom IUPAC … Wikipédia en Français
Propofol — Systematic (IUPAC) name 2,6 diisopropylphenol … Wikipedia
Methohexital — Systematic (IUPAC) name 5 hex 3 yn 2 yl 1 methyl 5 prop 2 enyl 1, 3 diazinane 2,4,6 trione Clinical data AHFS/Drugs.com … Wikipedia