Etomidate is indicated by intravenous injection for the induction of general anesthesia. When considering use of Etomidate, the usefulness of its hemodynamic properties should be weighed against the high frequency of transient skeletal muscle movements. Intravenous Etomidate is also indicated for the supplementation of subpotent anesthetic agents, such as nitrous oxide in oxygen, during maintenance of anesthesia for short operative procedures such as dilation and curettage or cervical conization.
General (Intravenous) anesthetics
Etomidate Injection is intended for administration only by the intravenous route. The dose for induction of anesthesia in adult patients and in pediatric patients above the age of ten (10) years will vary between 0.2 and 0.6 mg/kg of body weight, and it must be individualized in each case. The usual dose for induction in these patients is 0.3 mg/kg, injected over a period of 30 to 60 seconds. There are inadequate data to make dosage recommendations for induction of anesthesia in patients below the age of ten (10) years; therefore, such use is not recommended. Geriatric patients may require reduced doses of etomidate. Smaller increments of intravenous etomidate may be administered to adult patients during short operative procedures to supplement subpotent anesthetic agents, such as nitrous oxide. The dosage employed under these circumstances, although usually smaller than the original induction dose, must be individualized. There are insufficient data to support this use of etomidate for longer adult procedures or for any procedures in pediatric patients; therefore, such use is not recommended. The use of intravenous fentanyl and other neuroactive drugs employed during the conduct of anesthesia may alter the etomidate dosage requirements. Consult the prescribing information for all other such drugs before using. Premedication: Etomidate Injection is compatible with commonly administered pre-anesthetic medications, which may be employed as indicated. Etomidate hypnosis does not significantly alter the usual dosage requirements of neuromuscular blocking agents employed for endotrachealintubation or other purposes shortly after induction of anesthesia. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. To prevent needle-stick injuries, needles should not be recapped, purposely bent, or broken by hand.
Etomidate is contraindicated in patients who have shown hypersensitivity to it. Patient with cortico-adrenal insufficiency (e.g. patient with sepsis), pre-existing epilepsy, hepatic cirrhosis. Renal impairment. Elderly and childn. Pregnancy and lactation.
Excitatory phenomena e.g. myoclonus; pain on inj site; hyperventilation, hypoventilation, apnoea, hiccups and snoring, HTN, hypotension, postoperative nausea and vomiting. Rarely, convulsions, cardiac arrhythmias, laryngospasm.
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
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