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Etomidate

Aka: Etomidate, Amidate
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  1. Mechanism
    1. Imidazole derivative
    2. Sedation agent with minimal Analgesic effect
  2. Contraindications
    1. Hypersensitivity to Etomidate
  3. Indication
    1. Agent of choice in adult Conscious Sedation
      1. Fracture or dislocation reduction
      2. Significant Wound Debridement
      3. Rectal foreign body
      4. Ketamine is usually preferred in children
    2. Sedation in Rapid Sequence Intubation
      1. Intubation Agent of choice in Trauma
      2. Intubation agent of choice in Heart Failure
  4. Dose: Sedation prior to intubation
    1. Adult: 0.2 mg/kg over 30-60 seconds IV
    2. Child: 0.2-0.3 mg/kg IV
      1. Ketamine is usually preferred in children
  5. Pharmacokinetics
    1. Onset: Within 1 minute of IV dose
    2. Duration: 3-5 minutes (up to 10 minutes in some cases)
    3. Metabolized by liver
      1. Effect may be prolonged in liver failure
  6. Pregnancy
    1. Pregnancy Category C
  7. Adverse effects
    1. Nausea or Vomiting on emergence from agent
    2. Muscle twitching
    3. Respiratory depression in up to 15% of cases
      1. Responds to Supplemental Oxygen
      2. Positive Pressure Ventilation is rarely needed
    4. Adrenal suppression (not Clinically Significant)
  8. References
    1. Brown (2005) Am Fam Physician 71:85-90
    2. Vinson (2002) Ann Emerg Med 39:592-8

Amidate (C0718463)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
English Amidate
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Etomidate (C0015131)

Definition (MSH) Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.
Definition (NCI) An imidazole derivative with short-acting sedative, hypnotic, and general anesthetic properties. Etomidate appears to have gamma-aminobutyric acid (GABA) like effects, mediated through GABA-A receptor. The action enhances the inhibitory effect of GABA on the central nervous system by causing chloride channel opening events which leads to membrane hyperpolarization.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D005045
SnomedCT 387218008, 40429005
English Ethomidate, Etomidate, 1H-Imidazole-5-carboxylic acid, 1-(1-phenylethyl)-, ethyl ester, (R)-, etomidate, 1H-Imidazole-5-Carboxylic Acid, 1-((1R)-1-phenylethyl)-, Ethyl Ester, R-(+)-Ethyl 1-(1-phenylethyl)-1H-imidazole-5-carboxylate, etomidate (medication), sedatives etomidate, ETOMIDATE, Etomidate [Chemical/Ingredient], ethomidate, Etomidate (product), Etomidate (substance)
Swedish Etomidat
Czech etomidát
Finnish Etomidaatti
Russian ETOMIDAT, ЭТОМИДАТ
Japanese エトミダート, エトミデート
Polish Etomidate
Spanish etomidato (producto), etomidato (sustancia), etomidato, Etomidato
French Étomidate
German Etomidat
Italian Etomidato
Portuguese Etomidato
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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