NATIONAL
CALIFORNIA
VENTURA
category
mechanism
- Ultra-short-acting general anesthetic used for rapid induction of anesthesia with minimal cardiovascular effects.
Note: Provides no analgesic effects.
indications
- Rapid sequence intubation
contraindications
- Hypersensitivity to etomidate or any component of the formulation
dosing
Adult
IV, IO: 0.3 mg/kg; consider 0.2 mg/kg in hemodynamically unstable patients
Pediatric
IV, IO: 0.2 to 0.4 mg/kg/dose as a single dose; maximum dose: 20 mg/dose
administration
IV: Administer IV push over 30 to 60 seconds.
onset
30 to 60 seconds
peak
1 minute
duration
3 to 5 minutes
notes
- Adrenal steroid production: Etomidate inhibits 11-B-hydroxylase, an enzyme important in adrenal steroid production. A single induction dose blocks the normal stress-induced increase in adrenal cortisol production for 6 to 8 hours, up to 24 hours in elderly and debilitated patients.
- Heart failure: In a scientific statement from the American Heart Association, etomidate has been determined to be an agent that may exacerbate underlying myocardial dysfunction.
- Renal impairment: Risk of toxicity is greater in patients with renal impairment; use with caution.
- Older adult: May induce cardiac depression in elderly patients, especially those with hypertension; may require lower doses.
- Pediatric: Not recommended for patients in septic shock due to an association between transient adrenocortical suppression and increased mortality rate.
dosage form
Solution, Intravenous: 2 mg/mL (10 mL, 20 mL)
brand name
Amidate
adverse reactions
- Central nervous system
- Myoclonus
- Endocrine & metabolic
- Adrenal suppression
- Gastrointestinal
- Nausea
- Vomiting (on emergence from anesthesia)
- Hiccups
- Local
- Pain at injection site
- Neuromuscular & skeletal
- Transient skeletal movements
- Ophthalmic
- Nystagmus
structure
