INDICATIONS : ETOMIDATE
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More on Etomidate Below
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Etomidate (marketed as Amidate) is a short acting intravenous anesthetic agent used for the induction of general anesthesia and for sedation for short procedures such as reduction of dislocated joints and cardioversion. It was discovered at Janssen Pharmaceutica in 1964.
Etomidate is commonly used in the emergency setting as part of a rapid sequence induction to induce anesthesia or for conscious sedation.
In the operating room with a stable patient, anesthesia providers may choose an alternative induction agent, such as propofol, thiopental or methohexital rather than etomidate . At the typical dose, anesthesia is induced for about 5–10 minutes even though the half-life of drug metabolism is approximately 75 minutes. This is because etomidate is redistributed from the plasma to other tissues.
Etomidate is often used in this setting since it has a rapid onset of action and a low cardiovascular risk profile, and therefore is less likely to cause a significant drop in blood pressure than other induction agents. Etomidate is unlikely to cause hypotension and so is ideal to use as an induction agent with critically-ill patients, such as patients with sepsis, without negative effects from transient worsening of low blood pressure.
Side effects: Etomidate suppresses corticosteroid synthesis in the adrenal cortex by reversibly inhibiting 11-beta-hydroxylase. Using a continuous etomidate infusion for sedation of critically ill patients in intensive care units has been associated with increased mortality due to adrenal suppression. In addition, concurrent use of etomidate with opioids and/or benzodiazepines, which independently and characteristically lower cortisol levels, significantly exacerbates this side effect. This is especially significant because many patients who are given etomidate are already on some form of narcotic pain reliever. Also, benzodiazepines like diazepam and lorazepam are used extensively - both in emergency medicine and in the treatment of psychiatric illnesses and seizure disorders.
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What is Anesthesia? An anesthetic (anaesthetic), is a drug that causes anesthesia — reversible loss of sensation. They contrast with analgesics (painkillers), which relieve pain without eliminating sensation. These drugs are generally administered to facilitate surgery. A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside of anesthesia, although others are used commonly by all disciplines. Anesthetics are categorized in to two classes: general anesthetics, which cause a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body while maintaining consciousness. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects, however, adverse effects may also be increased.
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