Etomidate

CLINICAL USE

Induction of anaesthesia

DOSE IN NORMAL RENAL FUNCTION

150–300 mcg/kg

PHARMACOKINETICS

Molecular weight :244.3

%Protein binding :76

%Excreted unchanged in urine : 2

Volume of distribution (L/kg) :2–4.5

half-life – normal/ESRD (hrs) :4–5/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Unknown dialysability. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAdrenergic neurone blockers: enhanced hypotensive effectAntihypertensives: enhanced hypotensive effect

Antidepressants: avoid MAOIs for 2 weeks before surgery; increased risk of arrhythmias and hypotension with tricyclics

Antipsychotics: enhanced hypotensive effect

ADMINISTRATION

Reconstition

Route

Intravenous injection only

Rate of Administration

–

Comments

–

OTHER INFORMATION

In cases of adrenocortical gland dysfunction and during very long surgical procedures, a prophylactic cortisol supplement may be required (e.g. 50–100 mg hydrocortisone)

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