Etomidate (Amidate)

Question 1

Class / Action

Answer 1

Non-narcotic, non-barbiturate, sedative hypnotic
1. Depresses the activity of the brain stem reticular activating system. It may lower intraocular and intracranial pressure, and lower the rate of cerebral oxygen utilization, all with minimal cardiovascular and respiratory depressant effects.

Question 2

Onset / Duration of Action

Answer 2

Onset within 10-60sec / Dose-dependent Duration but can be ~3-5min with full recovery in 15min

Question 3

Indications

Answer 3

1. Induction agent for RSI in adults and pediatric patients >9years old
2. Sedation prior to cardioversion

Question 4

Contraindications

Answer 4

1. Known hypersensitivity to the agent

2. Not recommended for pregnant or nursing mothers

Question 5

Precautions

Answer 5

Elderly patients

Question 6

Dosages / Administration

Answer 6

1. ADULT:
   a. Induction Agent: 0.3mg/kg IV/IO Push over 30-60seconds
   b. Sedation Agent: 0.1mg/kg IV/IO
2. PED: 0.3mg/kg IV/IO Push over 30-60seconds; Max Dose: 20mg

Question 7

Adverse Reaction

Answer 7

1. Painful myoclonus (diffuse muscle contraction) which may be painful after patient awakens. This can be reduced by giving muscle relaxants immediately after Etomidate is given.
2. Pain at the injections site, moderated by using a large vessel and giving with IV fluid.
3. Apnea, Hypotension, Tachycardia, Nausea, Vomiting