Evaluation of Three Preparations of Etomidate

Zacharias, M; Clarke, R.S.J.; Dundee, John W.; Johnston, S.B.

doi:10.1093/bja/50.9.925

Cited by 30 publications

(4 citation statements)

References 14 publications

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“…53–55 Pain on injection was found to be worse with etomidate in aqueous solutions in comparison to the formulation in 35% propylene glycol. 56 Formulation into medium chain-length lipids or cyclodextrins appears to further decrease the incidence of injection pain and hemolysis. 9,57 Myoclonus has been shown to increase with etomidate dose and can be attenuated by split-dose induction 58 or premedication with benzodiazepines, 59 thiopental, dexmedetomidine 60 , and/or opioids.…”

Section: Clinical Pharmacologymentioning

confidence: 99%

“…Early investigators reported that post-operative nausea and vomiting incidence after induction with etomidate is around 40%, 50,55 comparable to that following barbiturates, 43,56 and higher than that following propofol. 63 More recently, the incidence of nausea after induction with etomidate in lipid emulsion was reported to be similar to that associated with propofol, 64,65 while the incidence of vomiting was higher with etomidate.…”

Section: Clinical Pharmacologymentioning

confidence: 99%

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Clinical and Molecular Pharmacology of Etomidate

2011

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This review focuses on the unique clinical and molecular pharmacology of etomidate. Among general anesthesia induction drugs, etomidate is the only imidazole, and it has the most favorable therapeutic index for single bolus administration. It also produces a unique toxicity among anesthetic drugs-- inhibition of adrenal steroid synthesis that far outlasts its hypnotic action and that may reduce survival of critically ill patients. The major molecular targets mediating anesthetic effects of etomidate in the central nervous system are specific γ-aminobutyric acid type A receptor subtypes. Amino acids forming etomidate binding sites have been identified in transmembrane domains of these proteins. Etomidate binding site structure models for the main enzyme mediating etomidate adrenotoxicity have also been developed. Based on this deepening understanding of molecular targets and actions, new etomidate derivatives are being investigated as potentially improved sedative-hypnotics or for use as highly selective inhibitors of adrenal steroid synthesis.

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Section: Clinical Pharmacologymentioning

confidence: 99%

Section: Clinical Pharmacologymentioning

confidence: 99%

Clinical and Molecular Pharmacology of Etomidate

2011

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“…3,4 However, the frequency of reactions differs from one study to another. In our knowledge, there is no study to evaluate the venous complications of 6 different iv anesthetic agents.…”

Section: Introductionmentioning

confidence: 99%

Effects of intravenous anesthetic agents on vascular endothelium

Gurbet

Kaya²,

Bayraktar³

et al. 2012

J Clin Exp Invest

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“…Although etomidate has been used widely as an induction agent, it has the disadvantage of causing pain on injection and excitatory movements (Miller, Hendry and Lees, 1978;Zacharias et al, 1978) when given as a bolus. However, because of its lack of cumulation (Kay, 1976) it can be used as an infusion to maintain anaesthesia.…”

mentioning

confidence: 99%