Etomidate

DEA Class;  Rx

Common Brand Names; Amidate

  • General Anesthetics, Systemic

Short-acting sedative-hypnotic
Used for general anesthesia during short procedures
Rapid onset of action and recovery with minimal cardiac and respiratory-depressive effects, no histamine release

Indicated for general anesthesia induction.

For the supplementation of subpotent anesthetic agents (e.g., nitrous oxide) during general anesthesia maintenance for short operative procedures such as obstetric anesthesia for dilation and curettage or cervical conization.
For sedation during rapid-sequence intubation.
For procedural sedation.
For the acute treatment of severe hypercortisolism in patients with Cushing’s syndrome (Cushing’s disease).

Hypersensitivity

Transient injection site pain (30-80%)

Skeletal muscle movements, mainly myoclonic (32%)

Opsoclonus (20%)

Adrenal suppression

Hiccups

Apnea (duration: 5-90 seconds)

Arrhythmias

Hyperventilation

HTN

Hypotension

Hypoventilation

Laryngospasm

Nausea/vomiting

Oxygen desaturation

Snoring (may be associated with partial upper airway obstruction)

Adrenal suppression (and prolonged therapy)

Prolonged infusion associated with suppression of endogenous cortisol and aldosterone production; formulation is not intended for prolonged infusion

Exacerbations of underlying myocardial dysfunction reported; monitor

Risk of toxicity may increae in patients with renal impairment; used caution; monitor renal function

Elderly patients may require lower doses; use associated with cardiac depression, especially those with hypertension

Safety during labor and delivery not elucidated; not recommended

There are no adequate and well-controlled studies in pregnant women

There are insufficient data to support intravenous use in obstetrics, including Caesarean section deliveries; such use not recommended

Not known whether drug is excreted in human milk; because many drugs are excreted in human milk, caution should be exercised when administered to a nursing mother.

Adults

Specific maximum dosage information is not available. Dosage must be individualized.

Geriatric

Specific maximum dosage information is not available. Dosage must be individualized.

Adolescents

Specific maximum dosage information is not available. Dosage must be individualized. 0.4 mg/kg/dose IV (Max: 20 mg/dose) has been used off-label as a sedative during rapid-sequence intubation.

Children

10 to 12 years: Specific maximum dosage information is not available. Dosage must be individualized. 0.4 mg/kg/dose IV (Max: 20 mg/dose) has been used off-label as a sedative during rapid-sequence intubation.
1 to 9 years: Safety and efficacy have not been established; however, 0.4 mg/kg/dose IV (Max: 20 mg/dose) has been used off-label as a sedative during rapid-sequence intubation.

Infants

Safety and efficacy have not been established; however, 0.4 mg/kg/dose IV (Max: 20 mg/dose) has been used off-label as a sedative during rapid-sequence intubation.

Etomidate

injectable solution

  • 2mg/mL

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