Etomidate(R-16659) is a GABAA receptors agonist, which is a short acting intravenous anaesthetic agent used for the induction of general anaesthesia.Target: GABA ReceptorEtomidate is a potent inhibitor of the adrenal response to surgery. The absence of clinical consequences associated with the blunted response suggests that a major increase in adrenal hormone production may not be necessary during surgery [1]. Etomidate is an intravenous induction agent that is associated with hemodynamic stability during intubation. The agent is therefore attractive for use in critically ill patients who have a high risk of hemodynamic instability during this procedure [2]. Etomidate use was not associated with all cause 28-day mortality or hospital mortality but was associated with significantly higher ICU mortality (91% vs. 64% for etomidate and controls groups, respectively; p = 0.02). Etomidate patients who received subsequent doses of hydrocortisone required lower doses of vasopressors and had more vasopressor-free days but no improvement in mortality [3].Clinical indications: FDA Approved Date: 1983Toxicity: Undesirable side effects of etomidate that may limit its use include pain on injection, myoclonus and adrenocortical suppression lasting 4-6 hours following an induction dose.
References:
[1]. Griesdale, D.E., Etomidate for intubation of patients who have sepsis or septic shock - where do we go from here Crit Care, 2012. 16(6): p. 189.
[2]. Cherfan, A.J., et al., Etomidate and mortality in cirrhotic patients with septic shock. BMC Clin Pharmacol, 2011. 11: p. 22.
[3]. Mehta, M.P., et al., Etomidate anesthesia inhibits the cortisol response to surgical stress. Acta Anaesthesiol Scand, 1985. 29(5): p. 486-9.