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Etomidate

    Brands

    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