Etomidate

Question 1

Etomidate Chemical Name and Class

Answer 1

R-1-methyl-1-(a-methylbenzyl) imidazole-5-carboxylate

Carboxylated imidazole derivate

Class: Hypnotic

Question 2

Etomidate Uses

Answer 2

Induction of anesthesia

Helpful in CV instability and Trauma Pts

Question 3

Etomidate MOA

Answer 3

Binds to the GABA-a receptor

Lower doses: potentiates GABA at its receptors

Higher doses: directly stimulates the GABA receptor

Question 4

Etomidate Induction Dose

Answer 4

Induction Dose: 0.3 mg/kg

Question 5

Etomidate Onset and Duration

Answer 5

Onset: 1 minute
Duration: 5 -15 minutes

Question 6

Etomidate Metabolism

Answer 6

Metabolism: Hepatic P450 enzymes and plasma esterases

Question 7

Etomidate Excretion

Answer 7

Excreted by kidneys and in bile

No active metabolite

Question 8

Etomidate CNS Effects (3)

Answer 8

Reduces intracranial pressure, cerebral blood flow, CMO2

Myoclonia likely related to an imbalance of excitatory and inhibitory pathways in the thalamacortical tract and can
induce EEG seizure foci

No analgesia

Question 9

Etomidate CV Effects (3)

Answer 9

Hemodynamically stable

Minimal/no cardiac depression

Does not blunt sympathetic response to laryngoscopy

Question 10

Etomidate Pulmonary Effects (3)

Answer 10

Brief hyperventilation followed by apnea

Mild respiratory depression (less than propofol)

No histamine release

Question 11

Etomidate Endocrine Effects (1)

Answer 11

Inhibits cortisol; adrenal suppression via suppression of 11-beta hydroxylase (lasts a while)

Question 12

Etomidate GI Effects (1)

Answer 12

N/V in 30-40% of patients

Question 13

Etomidate Hematologic Effects (1)

Answer 13

May induce acute intermittent porphyria