Etomidate

Registered South African indications:

• Induction of anaesthesia

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy
• Breastfeeding 
• Renal impairment
• Elderly
• Debilitated patients
• Cortico-adrenal insufficiency
• Prolonged use

Forms avail. in SA and covered in this monograph: inj

Induction of anaesthesia 
Sedation

• IV: 0.2-0.3mg/kg, as an infusion over 60 seconds; Max: 60mg/dose

Forms avail. in SA and covered in this monograph: inj

Induction of anaesthesia
Sedation

• IV: 0.2-0.3mg/kg, as an infusion over 60 seconds; Max: 60mg/dose

Children younger than 15 years may require up to an additional 30% supplementary dose 

Pregnancy

• Caution
• Etomidate is known to cross the placenta.  Etomidate may affect foetal brain development if used repeatedly or over extended periods as evidenced in animal studies. Use with caution, especially during the 3rd trimester of pregnancy and only if benefits outweigh risks. Use during pregnancy for procedures lasting 3 hours or more, should be carefully evaluated

Breastfeeding

• Caution
• Etomidate is excreted in breast milk. Use of etomidate during breastfeeding is acceptable, however, caution should be exercised, taking into consideration the risk to the breastfed infant

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; dose adjustment recommended
  Induction of anaesthesia: Initial: 0.2mg/kg, as an infusion over 60 seconds. Max: 30mg/dose
  Avoid giving any supplementary doses

Porphyria Information

• Possibly porphyrinogenic (PSP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Dyskinesia 
• Myoclonus 
• Hypertonia
• Involuntary muscle contractions 
• Nystagmus
• Seizures

Cardiovascular Disorders

• Bradycardia
• Extrasystoles
• Ventricular extrasystoles
• Cardiac arrest 
• Atrioventricular block 
• Vein pain
• Hypotension 
• Phlebitis 
• Hypertension
• Circulatory shock
• Thrombophlebitis

Respiratory Disorders

• Apnoea 
• Hyperventilation
• Stridor
• Hypoventilation
• Hiccups 
• Cough
• Respiratory depression
• Bronchospasm

Gastrointestinal Disorders

• Nausea and vomiting
• Salivary hypersecretion

Endocrine and Metabolic Disorders

• Adrenal insufficiency

Musculoskeletal Disorders

• Muscle rigidity
• Trismus

Skin and Subcutaneous Tissue Disorders

• Rash
• Erythema
• Stevens-Johnson syndrome
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity

• Neuroleptic agents
• Opiods
• Sedatives
• Alcohol
• Antihypertensives

None routine

Injection 20mg/10ml - EML (Hospital) 

Etomidate is a non-barbiturate, short acting hypnotic that acts at the level of the reticular-activating system to produce anesthesia. It is an imidazole compound that appears to depress central nervous system function via gamma-aminobutyric acid (GABA). Etomidate binds at a distinct site associated with a chloride ionopore at the GABA-A receptor, increasing the duration of time for which the chloride ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged.

Injection (per ml) 2mg

• B.Braun Etomidate (B Braun)
• Hypnomidate (Piramal Critical) originator