Etomidate

Aliases: Amidate  

Indications: Temporary Procedural Sedation     

Contraindications: Hypersensitivity to Etomidate. Coma  

Concentrations: 

Injection: 2 mg/mL

Dosing

Adult:

Indication	Dose	Route	Note
Rapid Sequence Induction	0.3 mg/kg	IV	Give once. Consider half dose in the setting of shock
Brief Procedural Sedation	0.1 mg/kg	IV	Give once. Consider half dose in the setting of shock

Pediatric:

Indication	Dose	Route	Note
Rapid Sequence Induction	0.3 mg/kg Max 40mg	IV	Give once. Consider half dose in the setting of shock
Brief Procedural Sedation	0.1 mg/kg Max 20mg	IV	Give once. Consider half dose in the setting of shock

Precautions: None

Adverse/Side Effects: Apnea/respiratory depression, bradycardia, myoclonus (muscle spasms), hypotension, nausea/vomiting   

Class: Sedative

Mechanism of Action: Etomidate appears to facilitate GABAminergic neurotransmission by increasing the number of available GABA receptors, possibly by displacing endogenous inhibitors of GABA binding. Etomidate also inhibits steroidogenesis, which prevents its long-term use for ICU sedation. Inhibition is probably due to blockage of 11-beta-hydroxylation within the adrenal cortex. Reduced plasma cortisol and aldosterone levels appear to be unresponsive to ACTH stimulation. 

Onset of Action	Peak Effect	Duration of Action
<1 minute	Rapid	3-5 minutes