ADMINISTRATION ROUTES:
IV
ALTERNATIVE NAMES:
Etomidate
ICU INDICATIONS:
- Induction of anaesthesia (particularly in the hypotensive patient)
PRESENTATION AND ADMINISTRATION:
IV:
20 mg in 10 mL vial
Inject undiluted by slow IV injection
Store at room temperature
DOSAGE:
IV:
0.3 mg/kg slow IV push
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
IV:
0.3 mg/kg slow IV push
CLINICAL PHARMACOLOGY:
Etomidate is a hypnotic drug without analgesic activity. Intravenous injection of etomidate produces hypnosis characterised by a rapid onset of action, usually within 1 minute. Duration of hypnosis is dose dependent but relatively brief, usually 3-5 minutes when an average dose of 0.3 mg/kg is employed. Reduced cortisol plasma levels have been reported with induction doses of 0.3 mg/kg. These persist for approximately 6-8 hours and appear to be unresponsive to ACTH
CONTRAINDICATIONS:
- Hypersensitivity to etomidate
WARNINGS:
Because of the hazards of prolonged suppression of endogenous cortisol and aldosterone production , etomidate should NOT be administered by prolonged infusion
PRECAUTIONS:
General:
See WARNINGS
Laboratory Tests:
No tests additional to routine ICU tests are required
Drug/Laboratory Test Interactions:
None of note
IMPORTANT DRUG INTERACTIONS IN ICU:
None of note
ADVERSE REACTIONS:
Body as a Whole:
Anaphylaxis, adrenal suppression
Central Nervous System:
Myoclonus
Cardiovascular System:
Hypertension, hypotension, tachycardia, bradycardia and other arrhythmias have occasionally been observed during induction and maintenance of anaesthesia
Respiratory System:
Hyperventilation, hypoventilation, apnoea of short duration (5-90 seconds with spontaneous recovery), laryngospasm, hiccup and snoring suggestive of partial upper airway obstruction have been observed in some patients
Gastrointestinal System:
Nausea and vomiting