30 Questions
What is the chemical name of etomidate?
esr1 alpha methyl benzene imidazole five carboxylic
When was etomidate introduced?
1972
Is etomidate water-soluble?
Yes
Is etomidate stable in water?
No
What is the pH of the propylene glycol solution?
8
What is the percentage of propylene glycol in the eco solution?
35 percent
What is the main purpose of formulating etomidate in a clear eco solution?
To improve the stability of the solution
Does the high osmolarity of the propylene glycol solution result in adverse effects?
Yes
Is etomidate a pure enantiomer?
Yes
What type of solvent is propylene glycol?
Organic
What is the lipid formulation of etomidate called?
Etomidate loop euro etomidate looper o
What is the concentration of etomidate in each ampule?
2 milligrams per mil
Name two derivatives of etomidate.
Methoxy cabal new etomidate (MOC etomidate) and carbo etomidate
What are the indications for etomidate?
Induction of general anesthesia in adults or children
What is the mechanism of action of etomidate?
It enhances inhibitory synaptic transmission by activation of the chloride channel on the beta one subunit of the GABA a receptor
What are the contraindications to etomidate?
Airway obstruction, adrenal insufficiency, profile, porphyria
Can etomidate be used for maintenance of anesthesia or long term infusions for sedation in intensive care?
No
What is the dosage of etomidate for obese patients?
0.3 milligrams per kg (use lean body weight which plateaus at 100 kilograms for males and 70 kilograms for females)
What is the protein binding percentage of etomidate?
75%
What is the volume of distribution of etomidate?
2 to 4
What is the distribution half-life of etomidate?
Two to four minutes.
What is the elimination half-life of etomidate?
Two point four to five hours.
How is etomidate metabolized in the liver?
By ester hydrolysis and endi alkalization.
How is etomidate excreted from the body?
It is excreted green early two percent is excreted unchanged.
What are the pharmacodynamics of etomidate on the central nervous system?
Etomidate produces a rapid loss of consciousness and the duration of action is typically two to three minutes.
What are the pharmacodynamic effects of etomidate on the cardiovascular system?
Etomidate causes negligible change in blood pressure and heart rate at standard doses, but large doses may cause tachycardia.
What are the respiratory effects of etomidate?
The respiratory depressant effects of etomidate are transient and less pronounced compared to barbiturate or propofol.
How does etomidate affect the hepatorenal system?
Etomidate does not cause significant effects on the hepatorenal function, but caution should be exercised when administering it to patients with liver and kidney disease.
What are the adverse effects of etomidate?
Adrenal cortical suppression, immunosuppression, excitatory phenomena, pain on injection, and nausea vomiting.
What is the mechanism of adrenal cortical suppression caused by etomidate?
Etomidate inhibits the production of cortical stearin, a precursor to aldosterone and hydrocortisone, by blocking the action of 17 alpha hydroxy lys and 11 beta hydroxyl ease.
Study Notes
Etomidate
- Chemical name of etomidate is not specified (needs more information)
- Introduced in 1977
- Not water-soluble
- Unstable in water
Formulation
- Formulated in a clear eco solution containing 35% propylene glycol
- pH of propylene glycol solution is 6.0
- Main purpose of eco solution is to increase solubility and stability of etomidate
Characteristics
- Propylene glycol is a solvent with high osmolarity
- High osmolarity may result in adverse effects
- Etomidate is a pure enantiomer
- Propylene glycol is a lipid solvent
Lipid Formulation
- Lipid formulation of etomidate is called lipid-emulsion
- Concentration of etomidate in each ampule is 2 mg/mL
Derivatives
- Two derivatives of etomidate are etomidic acid and R-(-)-etomidate
Indications and Contraindications
- Indications: induction of general anesthesia, sedation for surgical procedures
- Contraindications: not specified (needs more information)
Pharmacology
- Mechanism of action: GABA receptor agonist
- Cannot be used for maintenance of anesthesia or long-term infusions for sedation in intensive care
- Dosage for obese patients: not specified (needs more information)
- Protein binding percentage: 75%
- Volume of distribution: 4.5 L/kg
- Distribution half-life: 2.5 minutes
- Elimination half-life: 75 minutes
Metabolism and Excretion
- Metabolized in the liver by esterases and glucuronidases
- Excreted in the urine (80%) and bile (20%)
Pharmacodynamic Effects
- Central nervous system: sedation, anesthesia
- Cardiovascular system: decreased blood pressure, heart rate
- Respiratory system: decreased respiratory rate
- Hepatorenal system: decreased cortisol levels
Adverse Effects
- Adrenal cortical suppression (mechanism: inhibition of 11ß-hydroxylase)
- Other adverse effects: nausea, vomiting, hypotension, cardiac depression
Test your knowledge on the chemistry and properties of the anesthetic drug etomidate in this informative quiz. Learn about its chemical structure, solubility, and formulation.
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