| Name: |
ETOMIDATE (AmidateR) |
| Classification: |
sedative-hypnotic
- used as induction agent for intubation as general sedative or in rapid sequence induction (RSI)
- rapid onset of action usually within 60 seconds (may be 5-15 seconds) with duration of action of 3-5 minutes (may be up to 14 minutes)
- no analgesic activity; minimal respiratory or cardiovascular effects
Special access product
|
| Dose: |
- 0.3 mg/kg (0.2-0.6 mg/kg) to usual maximum of 20 mg IV
- Consider dose reduction in elderly patients
- Extensively excreted by kidney; patients with renal impairment may be more likely to experience toxic reactions. Specific dosing guidelines are not available.
|
| Administration: |
IV direct over 30-60 seconds
- use large proximal arm veins or central line if possible to avoid pain on injection
|
| Adverse Effects: |
- Injection site pain
- Hypotension or hypertension
- Tachycardia or bradycardia
- Arrhythmias
- Hypoventilation or hyperventilation, apnea
- Seizures
- Laryngospasm, hiccoughs
- Nausea/vomiting
- Dose related transient skeletal muscle movements including myoclonus (often masked by neuromuscular blockers)
- prolonged suppression of cortisol and aldosterone synthesis with continuous infusion or repeated dosing
|
| Monitoring Therapy: |
- Continuous heart rate and rhythm
- Blood pressure
- Respiratory rate
- Oxygen saturation
- End-tidal CO2
|
| Adult Critical Care Protocol: |
- Must be administered by MD trained in airway management with patient specific approval from senior resident or CCTC consultant.
- Monitoring sheet must be completed by administering physician and returned to Pharmacy Department.
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