Etomidate

20mg/10ml ampoules (IV)

Executive Summary

(January 2023)

Etomidate is an ultrashort-acting, non-barbiturate hypnotic intravenous anesthetic agent. Is one of the most used and preferred hypnotic agents in the ED for Rapid Sequence Intubation (RSI)(29). 

 

Pharmacology for a single bolus administration (23,28,29):

 

Adult dose for rapid sequence intubation:  
0.3mg/kg IV (total body weight).

Mechanism of Action and Usage

Etomidate is an imidazole derivative, with agonist activity to the β and βsubunits of the GABA receptor (11) increasing its activity by moderating chloride channels, inhibiting neuronal action by decreasing the action potential threshold (16, 23, 28, 29). 

Indications

US-FDA Labeled (34, 4):

Adult dose

Inductor dose for rapid sequence intubation
0.3mg/kg IV.

Pediatric dose

Inductor dose for rapid sequence intubation
0.3 mg/kg IV.

Renal, hepatic, or other adjustments

No renal or hepatic adjustments needed. 

Dosage Forms and brand names

Cautions, Contraindications, Adverse effects, and Major drug interactions

Bottom line




 

Pregnancy and Lactation

Amounts of etomidate in milk are small and decrease rapidly (7). Available data indicate that no waiting period is required before resuming breastfeeding after etomidate anesthesia. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia.


Pharmacology

(2, 4, 5, 9, 16, 23, 28, 29).

References

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EMDrugs Team