Table 6.
| Etomidate | |
|---|---|
| Group | Caroboxylated imidazole derivative |
| Mechanism of Action/Pharmakodynamics | GABAA receptor agonist |
|
| |
| Neuroprotective effects | Reduces CBF, CMRO2 and ICP Maintains or increases CPP Lowers seizure threshold |
|
| |
| Pharmacokinetics | 75% protein bound Highly lipid soluble High volume of distribution, three compartment model Hepatic metabolism Renal excretion (some bile) Short context sensitive t 1/2 (4.8 h) |
|
| |
| Advantages | Rapid onset of action as induction agent Only lasts 3–5 minutes after single bolus Favourable effects on CBF, CMRO2 and ICP |
|
| |
| Disadvantages and major side effects | Adrenal suppression Metabolic acidosis from propylene glycol vehicle Pain on injection Myoclonic movements Nausea and vomiting |
|
| |
| Dosage | Induction: 0.2–0.4 mg/kg |
|
| |
| Other significant facts | Originally developed as an anti-fungal agent |
|
| |
| Appropriate uses in TBI | Induction of anaesthesia, with caution regarding adrenal suppression |