Etomidate

Question 1

What is Etomidate and its primary use in anesthesia?

Answer 1

Etomidate is a short-acting intravenous anesthetic agent used for induction of anesthesia and procedural sedation, favored for its minimal cardiovascular effects.

Question 2

Describe the hemodynamic stability associated with Etomidate.

Answer 2

Etomidate causes minimal hypotension compared to other agents, making it ideal for patients with compromised cardiovascular function or hemodynamic instability.

Question 3

What are the onset and duration characteristics of Etomidate?

Answer 3

Etomidate has a rapid onset (30-60 seconds) and a short duration, suitable for quick induction and recovery in short procedures.

Question 4

How does Etomidate affect respiratory function?

Answer 4

Etomidate has minimal impact on respiratory function, usually not causing significant respiratory depression, advantageous in patients requiring spontaneous ventilation.

Question 5

Explain the cerebral protection offered by Etomidate.

Answer 5

Etomidate reduces intracranial pressure and cerebral metabolic rate, beneficial in neurosurgical procedures or traumatic brain injury to maintain cerebral perfusion.

Question 6

Detail Etomidate’s mechanism of action.

Answer 6

Etomidate acts by enhancing the GABA-A receptor’s affinity for GABA, increasing chloride ion conductance and leading to neuronal hyperpolarization and anesthetic effect.

Question 7

What are the key pharmacological properties of Etomidate?

Answer 7

Etomidate is a carboxylated imidazole, water-soluble at an acidic pH and lipid-soluble at physiological pH, acting selectively on GABAA receptors.

Question 8

Discuss the metabolism and elimination of Etomidate.

Answer 8

Etomidate is rapidly metabolized by hydrolysis of the ethyl ester side chain, primarily by hepatic microsomal enzymes and plasma esterases.

Question 9

What side effects are commonly associated with Etomidate induction?

Answer 9

Common side effects include involuntary myoclonic movements, hiccups upon injection, and an increased incidence of nausea and vomiting.

Question 10

How does Etomidate affect cerebral blood flow and metabolism?

Answer 10

Etomidate acts as a potent cerebral vasoconstrictor, decreasing cerebral blood flow and cerebral metabolic rate of oxygen consumption (CMRO2).

Question 11

Address Etomidate’s impact on adrenocortical function.

Answer 11

Etomidate suppresses adrenocortical function by inhibiting enzymes crucial for cortisol and aldosterone synthesis, leading to potential adrenocortical suppression.

Question 12

What are the cardiovascular effects of Etomidate?

Answer 12

Etomidate produces minimal cardiovascular disturbance, with little change in heart rate, stroke volume, or cardiac output, making it the least impactful among IV anesthetics.

Question 13

Explain the considerations for using Etomidate in patients with seizures.

Answer 13

Caution is advised when administering Etomidate to patients with a history of seizures, as it may stimulate seizure foci.

Question 14

Discuss the use of Etomidate in patients with respiratory conditions.

Answer 14

Due to its bronchodilatory effects and minimal respiratory depression, Etomidate is a good induction agent for patients with asthma or other respiratory issues.

Question 15

How does Etomidate’s analgesic mechanism compare to its anesthetic effects?

Answer 15

While Etomidate is primarily used for its anesthetic properties, it does not provide significant analgesia, necessitating the use of additional analgesics for pain management.

Question 16

Describe the caution needed when administering Etomidate regarding adrenal suppression.

Answer 16

Etomidate’s dose-dependent inhibition of adrenal steroid synthesis requires careful monitoring and consideration, especially in critically ill patients.

Question 17

What precautions should be taken to mitigate pain on injection with Etomidate?

Answer 17

Pain on injection is common with Etomidate, often managed by dilution or co-administration with a local anesthetic to reduce discomfort.

Question 18

Detail the effect of Etomidate on intraocular and intracranial pressures.

Answer 18

While beneficial for cerebral protection, Etomidate’s effects on intraocular pressure should be considered in patients with eye conditions.

Question 19

Explain how Etomidate’s pharmacokinetics are affected by liver or kidney disease.

Answer 19

Etomidate’s pharmacokinetics are generally not significantly affected by liver or kidney disease, owing to its rapid hydrolysis and elimination.