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Etomidate - Anesthetic Agent Overview

Etomidate

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marnialgbesseto000
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16 views11 pages

Etomidate - Anesthetic Agent Overview

Etomidate

Uploaded by

marnialgbesseto000
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Etomidate:

Anesthetic
Agent
Overview
July 3, 2024
Agenda

ー Introduction to Etomidate
ー Definition and Historical
Background
ー Mechanism of Action
ー Physicochemical Properties
ー Pharmacokinetics
ー Clinical Use and Indications
ー Adverse Effects and Drug
Interactions
ー Conclusion
Introduction to
Etomidate
Key Points

● Etomidate is a widely used intravenous anesthetic agent.

● Primarily used for the induction of general anesthesia.

● Notable for maintaining hemodynamic stability, making it ideal


for patients with cardiovascular risks.

● Induces rapid anesthesia with minimal respiratory depression.

● Has a low incidence of histamine release, reducing allergic


reactions.
Definition and
Historical
Background
Definition of Etomidate Historical Background

ー Intravenous non-barbiturate ー Developed in the 1960s and


anesthetic agent primarily used for introduced to the market in the
induction of general anesthesia 1970s

ー Preferred for its hemodynamic ー Commonly used in emergency


stability, making it ideal for patients situations and surgeries, especially
with cardiovascular risks for patients with unstable
hemodynamics
ー Rapid induction of anesthesia with
minimal respiratory depression ー Known for its stability in
compared to other anesthetics maintaining blood pressure and
cardiac output during anesthesia
Mechanism of
Action
Molecular Interaction Comparison with Other Agents

ー Etomidate enhances GABA_A ー Propofol also targets GABA_A,


receptor activity. but with more hemodynamic
instability.
ー Increases chloride ion influx,
causing neuronal inhibition. ー Thiopental acts on GABA_A
with longer duration of action.
ー Leads to rapid induction of
anesthesia (30-60 seconds). ー Etomidate provides better
cardiovascular stability.
Physicochemical Properties

Key Physicochemical Properties of


Etomidate

● Etomidate is unstable in aqueous solution and is liposoluble, promoting


central nervous system (CNS) binding with a pKa of 4.2.

● It is a weak acid and is usually formulated in an injectable solution with a


solvent such as propylene glycol to improve solubility.

● Etomidate has a protein and plasma binding rate of 75%.

● Compared to etomidate, propofol is also liposoluble but requires a lipid


emulsion formulation for administration.
Pharmacokinet
ics
Etomidate Pharmacokinetics Comparison with Other Agents

ー Rapid distribution with onset in ー Propofol has a longer


3 minutes elimination half-life

ー Metabolized primarily by ー Propofol metabolized mainly by


hepatic esterases the liver

ー Elimination half-life extended in ー Thiopental has a slower onset


cirrhosis and longer duration

ー No active metabolites and no ー Etomidate offers better


accumulation hemodynamic stability

ー Crosses the placental barrier ー Propofol may require lipid


emulsion for administration
Clinical Use and Indications

● Induction of general anesthesia: Effective for rapidly inducing anesthesia with


minimal hemodynamic impact.

● Hemodynamically unstable patients: Preferred due to its stability in cardiovascular


parameters, minimizing fluctuations in blood pressure and cardiac output.

● Emergency situations: Commonly used in emergency surgeries and procedures due


to its rapid onset and short duration of action.

● Procedures requiring sedation: Used for minor medical procedures where deep
sedation is necessary without significant respiratory depression.

● High-risk cardiovascular patients: Ideal for use in patients with coronary artery
disease or other cardiovascular conditions due to its minimal effect on myocardial
oxygen consumption and coronary perfusion.
Adverse
Effects and
Drug Steroid Biosynthesis Impact Etomidate inhibits 11β-hydroxylase, reducing cortisol and aldosterone

Interactions production. This can lead to adrenal insufficiency, particularly with prolonged
use.

Respiratory Depression While etomidate has a lower risk of respiratory depression compared to other
agents, overdose can still cause severe respiratory issues, necessitating close
monitoring.

CNS Depressants Interactions Etomidate can prolong the effects of CNS depressants like benzodiazepines and
opioids, leading to extended sedation and increased risk of respiratory
depression.

Other Adverse Effects Includes injection site pain, nausea, vomiting, and myoclonus. Pre-treatment
with benzodiazepines or opioids can reduce some of these effects.
Conclusion
Etomidate stands out as a valuable anesthetic agent due to its

rapid induction and hemodynamic stability, making it particularly

suitable for patients with cardiovascular risks. While it offers

significant advantages such as minimal respiratory depression and

low histamine release, it also poses risks like adrenal suppression

and potential drug interactions. Despite these risks, etomidate's

unique pharmacological profile ensures its continued importance

in modern anesthetic practice, especially in scenarios where

maintaining cardiovascular stability is crucial.


Thank you

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