에토미데이트

주사용 마취제 (비바르비투르산계)

에토미데이트는 속효성 주사용 비바르비투르산계 마취 유도제입니다. 수의학에서는 **심혈관계 안정성**이 뛰어나 심장 기능 장애, 두부 외상 또는 중증 환자에서 티오펜탈이나 프로포폴을 대체할 수 있는 훌륭한 약물로 평가받고 있습니다. **주요 임상 특징:** * **혈역학적 안정성:** 심박수와 혈압에 미치는 영향이 최소화되어 심장 질환이나 쇼크 환자에게 이상적입니다. * **신경학적 이점:** 뇌혈류, 뇌산소 소비량 및 두개내압을 감소시켜 두부 외상 환자에게 유익합니다. * **내분비계 영향:** 코르티솔 생성을 억제하므로 중증 환자에게는 코르티코스테로이드 보충이 필요할 수 있습니다. * **진통 효과 없음:** 수면 및 기억 상실 효과만 제공하므로 적절한 진통제와 반드시 병용해야 합니다.

작용 기전: While the exact mechanism is not definitively proven, etomidate is known to act primarily as a positive allosteric modulator and direct agonist at the **GABA_A receptor** in the central nervous system. * **Mechanism:** Binds to a specific site on the GABA_A receptor → enhances the affinity of the inhibitory neurotransmitter GABA for the receptor → increases transmembrane chloride conductance → hyperpolarizes the postsynaptic neuron → profound CNS depression and hypnosis. * **Endocrine Mechanism:** Directly inhibits **11-β-hydroxylase** (and to a lesser extent 17-α-hydroxylase) in the adrenal cortex → blocks the conversion of 11-deoxycortisol to cortisol → transient adrenal insufficiency.

동물 종별 용량

Cats

As an induction agent · 1 mg/kg IV plus diazepam 0.5 mg/kg IV · IV · Once
As an induction agent · 1-2 mg/kg rapidly IV · IV · Once
As an induction agent · 0.5-2 mg/kg IV · IV · Once · Pre-medication is highly recommended to reduce incidence of side effects (myoclonus, vomiting). May be given with a benzodiazepine. Administration of a physiologic dose of dexamethasone or another short-acting glucocorticoid prior to etomidate is suggested.

Ferrets

As an induction agent in the cardiovascular unstable patient · 1-2 mg/kg IV after diazepam (0.5 mg/kg IV) · IV · Once

SmallMammals

As an induction agent in the cardiovascular unstable patient (Rabbits) · 1-2 mg/kg IV after diazepam (0.5 mg/kg IV) · IV · Once

Dogs

As an induction agent · 1 mg/kg IV plus diazepam 0.5 mg/kg IV · IV · Once
As an induction agent · 1-2 mg/kg rapidly IV · IV · Once
As an induction agent · 0.5-2 mg/kg IV · IV · Once · Pre-medication is highly recommended to reduce incidence of side effects (myoclonus, vomiting). May be given with a benzodiazepine. Administration of a physiologic dose of dexamethasone or another short-acting glucocorticoid prior to etomidate is suggested.

투여 경로

금기

Known hypersensitivity to etomidate
Maintenance of anesthesia (due to cumulative adrenal suppression)
Use as a sole agent for painful procedures (lacks analgesia)

이상반응

Pain at intravenous injection site
Myoclonus (skeletal muscle movements)
Vomiting and post-operative retching
Eye movements
Hemolysis (due to propylene glycol carrier)
Brief hypoventilation and decreased arterial blood pressure
Apnea, laryngospasm, or hiccups (reported in humans)

약물 상호작용

CNS/Respiratory Depressants (e.g., barbiturates, opiates, anesthetics) · Additive pharmacological effects; can increase CNS or respiratory depression.
Verapamil · Associated with potentiating the anesthetic and respiratory depressant effects of etomidate.

모니터링

Level of consciousness
Respiration rate and depth
Cardiovascular function (blood pressure, heart rate, ECG)

과용량

Acute overdoses would be expected to cause enhanced pharmacologic effects of the drug, including profound CNS and respiratory depression. Treatment is supportive (e.g., mechanical ventilation, cardiovascular support) until the effects of the medication are diminished.

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