Etomidate

Question 1

What is MOA of etomidate?

Answer 1

GABA modulator

Question 2

What is the primary inhibitory neurotransmitter in the brain?

Answer 2

GABA

Question 3

What is the structure of etomidate?

Answer 3

• Carboxylated imidazole
• Ring open/ water soluble in solution
• Ring closes in body and becomes lipid soluble

Question 4

When is etomidate used for induction?

Answer 4

• Used when cardiac stability is needed
• Induces seizures (ECT?)
• Used in unstable patients

Question 5

What is the dose of etomidate?

Answer 5

0.3mg/kg (no decreasing or changing dose for elderly/sick)

Question 6

Which induction drug has the highest risk of PONV?

Answer 6

Etomidate (30% of patients)

Question 7

What is the pathophys of adrenocortical suppression from etomidate?

Answer 7

• Dose dependent inhibition of 11 B-hydroxylase
• That enzyme converts cholesterol to cortisol

Question 8

How long can adrenocortical suppression occur from etomidate?

Answer 8

• 4-8 hours
• Lowers post op cortisol levels in healthy patients

Question 9

What is the onset of etomidate?

Answer 9

1min

Question 10

How is etomidate metabolized?

Answer 10

Hydrolysis (hepatic microsomal enzymes and plasma esterases)

Question 11

Etomidate has high incidence of ________

Answer 11

Myoclonus (involuntary movements)