Diferencia entre revisiones de «Etomidate»

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''See [[critical care quick reference]] for drug doses by weight.''
''See [[critical care quick reference]] for drug doses by weight.''
==General==
==General==
*Type:  
*Type: [[Sedation|Sedative]]
*Dosage Forms:
*Dosage Forms: IV
*Common Trade Names:  
*Common Trade Names: Amidate, Tomvi


==Adult Dosing==
==Adult Dosing==
===[[RSI]]===
===[[RSI]]===
*0.3 mg/kg bolus IV  
*0.3mg/kg bolus IV  
*Standard dose = 20mg
*Average: 20mg
**Consider half-dose (0.15mg/kg) for obtunded patients


===[[Procedural Sedation]]===
===[[Procedural Sedation]]===
*0.15 mg/kg bolus IV
{{Procedure sedation etomidate}}
*Standard dose = 10mg)


==Pediatric Dosing==
==Pediatric Dosing==
''See [[critical care quick reference]] for drug doses by weight.''
''See [[critical care quick reference]] for drug doses by weight.''
==[[RSI]]==
*0.3 mg/kg bolus IV
*Max: 20mg


==[[Procedural Sedation]]==
*Children < 10 years
*(0.15 mg/kg bolus IV
**0.2-0.3 mg/kg IV
*Max: 10mg
*Children > 10 years
**0.3 mg/kg IV


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*Lactation:
*Lactation: etomidate is present in breast milk
*Renal Dosing
*Renal Dosing
**Adult
**Adult
*** Not defined however higher risk of toxicity with renal impairment
**Pediatric
**Pediatric
*** Not defined however higher risk of toxicity with renal impairment
*Hepatic Dosing
*Hepatic Dosing
**Adult
**Adult
*** Not defined
**Pediatric
**Pediatric
*** Not defined


==Contraindications==
==Contraindications==
Línea 39: Línea 40:


==Adverse Reactions==
==Adverse Reactions==
*Myoclonus
*Nausea/Vomiting
*Pain at injection site
* apnea
===Controversy===
===Controversy===
"The available evidence suggests that etomidate suppresses adrenal function transiently without
*May suppress adrenal function in critically ill patient
demonstrating a significant effect on mortality. However, no studies to date have been powered to detect a difference in hospital, ventilator, or ICU length of stay or in mortality."
**"The available evidence suggests that etomidate suppresses adrenal function transiently without
demonstrating a significant effect on mortality. However, no studies to date have been powered to detect a difference in hospital, ventilator, or ICU length of stay or in mortality."<ref>*Hohl CM, Kelly-Smith CH,Yeung TC, Sweet DD, Doyle-Waters MM, Schulzer M.  The effect of a bolus dose of Etomidate on cortisol levels, mortality, and health services utilization: a systematic review.  Ann Emerg Med. 2010;56(2):105-113.</ref>
*Meta-analysis in 2023 showed increased mortality in critically ill patients


==Pharmacology==
==Pharmacology==
*Half-life:  
*Half-life: 75 minutes
*Metabolism:  
*Metabolism: Liver
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: GABA agonist
 
 
==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''
 
{{#ask:[[Has DrugName::Etomidate]]
|?Has Indication=Indication
|?Has Dose=Dose
|?Has Context=Context
|?Has Route=Route
|?Has Population=Population
|format=table
|headers=plain
|mainlabel=-
|sort=Has Indication
|limit=50
}}


==See Also==
==See Also==


==Sources==
==References==
*Hohl CM, Kelly-Smith CH,Yeung TC, Sweet DD, Doyle-Waters MM, Schulzer M.  The effect of a bolus dose of Etomidate on cortisol levels, mortality, and health services utilization: a systematic review.  Ann Emerg Med. 2010;56(2):105-113.
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Drugs]]
[[Category:Critical Care]]
 
Etomidate: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Revisión actual - 21:57 20 mar 2026

See critical care quick reference for drug doses by weight.

General

  • Type: Sedative
  • Dosage Forms: IV
  • Common Trade Names: Amidate, Tomvi

Adult Dosing

RSI

  • 0.3mg/kg bolus IV
  • Average: 20mg
    • Consider half-dose (0.15mg/kg) for obtunded patients

Procedural Sedation

  • 0.1mg/kg one time dosing
  • Max: 10mg
  • Minimal respiratory depression but decrease blood pressure and heart rate (alpha2 agonism)

Pediatric Dosing

See critical care quick reference for drug doses by weight.

  • Children < 10 years
    • 0.2-0.3 mg/kg IV
  • Children > 10 years
    • 0.3 mg/kg IV

Special Populations

  • Pregnancy Rating: C
  • Lactation: etomidate is present in breast milk
  • Renal Dosing
    • Adult
      • Not defined however higher risk of toxicity with renal impairment
    • Pediatric
      • Not defined however higher risk of toxicity with renal impairment
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

  • Myoclonus
  • Nausea/Vomiting
  • Pain at injection site
  • apnea

Controversy

  • May suppress adrenal function in critically ill patient
    • "The available evidence suggests that etomidate suppresses adrenal function transiently without

demonstrating a significant effect on mortality. However, no studies to date have been powered to detect a difference in hospital, ventilator, or ICU length of stay or in mortality."[1]

  • Meta-analysis in 2023 showed increased mortality in critically ill patients

Pharmacology

  • Half-life: 75 minutes
  • Metabolism: Liver
  • Excretion: Urine
  • Mechanism of Action: GABA agonist


Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

IndicationDoseContextRoutePopulation
Procedural sedation0.15 mg/kgProcedural sedationIVAdult
Procedural sedation0.1-0.2 mg/kgProcedural sedation (solo)IVAdult
Rapid sequence intubation0.2-0.4 mg/kgInductionIVAdult

See Also

References

  1. ↑ *Hohl CM, Kelly-Smith CH,Yeung TC, Sweet DD, Doyle-Waters MM, Schulzer M. The effect of a bolus dose of Etomidate on cortisol levels, mortality, and health services utilization: a systematic review. Ann Emerg Med. 2010;56(2):105-113.

Etomidate: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.

Obtenido de «https://www.wikem.org/w/index.php?title=Etomidate&oldid=387513»