Etomidate: Difference between revisions

No edit summary
 
(6 intermediate revisions by 4 users not shown)
Line 1: Line 1:
''See [[critical care quick reference]] for drug doses by weight.''
''See [[critical care quick reference]] for drug doses by weight.''
==General==
==General==
*Type:  
*Type: [[Sedation|Sedative]]
*Dosage Forms:
*Dosage Forms:
*Common Trade Names:  
*Common Trade Names: Amidate


==Adult Dosing==
==Adult Dosing==
===[[RSI]]===
===[[RSI]]===
*0.3mg/kg bolus IV  
*0.3mg/kg bolus IV  
*Standard dose = 20mg
*Average: 20mg
**Consider halving does for patients in [[shock]]


===[[Procedural Sedation]]===
===[[Procedural Sedation]]===
{{etomidate procedural sedation}}
{{Procedure sedation etomidate}}


==Pediatric Dosing==
==Pediatric Dosing==
''See [[critical care quick reference]] for drug doses by weight.''
''See [[critical care quick reference]] for drug doses by weight.''
==[[RSI]]==
*0.3mg/kg bolus IV
*Max: 20mg
==[[Procedural Sedation]]==
{{procedure sedation etomidate}}


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation:
*Lactation: etomidate is present in breast milk
*Renal Dosing
*Renal Dosing
**Adult
**Adult
*** Not defined however higher risk of toxicity with renal impairment
**Pediatric
**Pediatric
*** Not defined however higher risk of toxicity with renal impairment
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
*** Not defined
**Pediatric
**Pediatric
*** Not defined


==Contraindications==
==Contraindications==
Line 56: Line 55:


[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:Critical Care]]
Etomidate: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Latest revision as of 16:42, 13 May 2021

See critical care quick reference for drug doses by weight.

General

  • Type: Sedative
  • Dosage Forms:
  • Common Trade Names: Amidate

Adult Dosing

RSI

  • 0.3mg/kg bolus IV
  • Average: 20mg
    • Consider halving does for patients in shock

Procedural Sedation

  • 0.1mg/kg one time dosing
  • Max: 10mg
  • Minimal respiratory depression but decrease blood pressure and heart rate (alpha2 agonism)

Pediatric Dosing

See critical care quick reference for drug doses by weight.

Special Populations

  • Pregnancy Rating: C
  • Lactation: etomidate is present in breast milk
  • Renal Dosing
    • Adult
      • Not defined however higher risk of toxicity with renal impairment
    • Pediatric
      • Not defined however higher risk of toxicity with renal impairment
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

  • Myoclonus
  • Nausea/Vomiting
  • Pain at injection site
  • apnea

Controversy

"The available evidence suggests that etomidate suppresses adrenal function transiently without demonstrating a significant effect on mortality. However, no studies to date have been powered to detect a difference in hospital, ventilator, or ICU length of stay or in mortality."[1]

Pharmacology

  • Half-life: 75 minutes
  • Metabolism: Liver
  • Excretion: Urine
  • Mechanism of Action: GABA agonist

See Also

References

  1. *Hohl CM, Kelly-Smith CH,Yeung TC, Sweet DD, Doyle-Waters MM, Schulzer M. The effect of a bolus dose of Etomidate on cortisol levels, mortality, and health services utilization: a systematic review. Ann Emerg Med. 2010;56(2):105-113.

Etomidate: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.