Etomidate
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Questions and Answers

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?

<p>No</p> Signup and view all the answers

What is the pH of the propylene glycol solution?

<p>8</p> Signup and view all the answers

What is the percentage of propylene glycol in the eco solution?

<p>35 percent</p> Signup and view all the answers

What is the main purpose of formulating etomidate in a clear eco solution?

<p>To improve the stability of the solution</p> Signup and view all the answers

Does the high osmolarity of the propylene glycol solution result in adverse effects?

<p>Yes</p> Signup and view all the answers

Is etomidate a pure enantiomer?

<p>Yes</p> Signup and view all the answers

What type of solvent is propylene glycol?

<p>Organic</p> Signup and view all the answers

What is the lipid formulation of etomidate called?

<p>Etomidate loop euro etomidate looper o</p> Signup and view all the answers

What is the concentration of etomidate in each ampule?

<p>2 milligrams per mil</p> Signup and view all the answers

Name two derivatives of etomidate.

<p>Methoxy cabal new etomidate (MOC etomidate) and carbo etomidate</p> Signup and view all the answers

What are the indications for etomidate?

<p>Induction of general anesthesia in adults or children</p> Signup and view all the answers

What is the mechanism of action of etomidate?

<p>It enhances inhibitory synaptic transmission by activation of the chloride channel on the beta one subunit of the GABA a receptor</p> Signup and view all the answers

What are the contraindications to etomidate?

<p>Airway obstruction, adrenal insufficiency, profile, porphyria</p> Signup and view all the answers

Can etomidate be used for maintenance of anesthesia or long term infusions for sedation in intensive care?

<p>No</p> Signup and view all the answers

What is the dosage of etomidate for obese patients?

<p>0.3 milligrams per kg (use lean body weight which plateaus at 100 kilograms for males and 70 kilograms for females)</p> Signup and view all the answers

What is the protein binding percentage of etomidate?

<p>75%</p> Signup and view all the answers

What is the volume of distribution of etomidate?

<p>2 to 4</p> Signup and view all the answers

What is the distribution half-life of etomidate?

<p>Two to four minutes.</p> Signup and view all the answers

What is the elimination half-life of etomidate?

<p>Two point four to five hours.</p> Signup and view all the answers

How is etomidate metabolized in the liver?

<p>By ester hydrolysis and endi alkalization.</p> Signup and view all the answers

How is etomidate excreted from the body?

<p>It is excreted green early two percent is excreted unchanged.</p> Signup and view all the answers

What are the pharmacodynamics of etomidate on the central nervous system?

<p>Etomidate produces a rapid loss of consciousness and the duration of action is typically two to three minutes.</p> Signup and view all the answers

What are the pharmacodynamic effects of etomidate on the cardiovascular system?

<p>Etomidate causes negligible change in blood pressure and heart rate at standard doses, but large doses may cause tachycardia.</p> Signup and view all the answers

What are the respiratory effects of etomidate?

<p>The respiratory depressant effects of etomidate are transient and less pronounced compared to barbiturate or propofol.</p> Signup and view all the answers

How does etomidate affect the hepatorenal system?

<p>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.</p> Signup and view all the answers

What are the adverse effects of etomidate?

<p>Adrenal cortical suppression, immunosuppression, excitatory phenomena, pain on injection, and nausea vomiting.</p> Signup and view all the answers

What is the mechanism of adrenal cortical suppression caused by etomidate?

<p>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.</p> Signup and view all the answers

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

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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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