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Etomidate
Related Subjects: |Respiratory Failure |Non invasive ventilation (NIV) |Intubation and Mechanical Ventilation |Critical illness neuromuscular weakness |Haemodialysis |Dobutamine
โ ๏ธ Etomidate is an IV anaesthetic agent withdrawn for continuous ICU sedation because of increased mortality due to adrenocortical suppression (inhibition of 11ฮฒ-hydroxylase). Still used for induction of anaesthesia, particularly in haemodynamically unstable patients. Always check the BNF link here.
๐ About
- Carboxylated imidazole compound (introduced 1972, Europe).
- IV anaesthetic & induction agent.
- Favoured in cardiovascularly unstable patients due to minimal effect on BP/HR.
โ๏ธ Mode of Action
- Short-acting IV anaesthetic.
- Inhibits 11ฮฒ-hydroxylase (CYP11B1) โ โ cortisol synthesis โ adrenal suppression.
- At high concentrations also inhibits cytochrome P450 enzymes.
๐ Indications & Dose
- Adults: 0.15โ0.3 mg/kg IV over 30โ60 seconds.
- Elderly: 0.15โ0.2 mg/kg IV over 30โ60 seconds.
- Onset: 5โ15 seconds. Recovery: 5โ15 minutes.
- Max per dose: 60 mg.
๐ Interactions
- See BNF.
โ ๏ธ Cautions
- Shock, adrenal insufficiency, acute porphyria.
- Cardiovascular disease, fixed cardiac output, hypovolaemia.
- Elderly patients (increased sensitivity).
๐ซ Contraindications
- See BNF.
โ Side Effects
- Apnoea, hypotension, nausea, skin reactions.
- Involuntary muscle movements (myoclonus).
- Adrenocortical suppression (clinically significant with prolonged infusion).
- โ intracranial pressure, โ cerebral blood flow, โ cerebral oxygen demand.
๐ References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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