依託咪酯
Etomidate
Carboxylic imidazole
別名: Amidate · Hypnomidate · Radenarcon · Sibul · R-16659
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an induction agent | 1 mg/kg IV plus diazepam 0.5 mg/kg IV | IV | Once | — | 🌎 NA |
| As an induction agent | 1-2 mg/kg rapidly IV | IV | Once | — | 🌎 NA |
| As an induction agent | 0.5-2 mg/kg IV | IV | Once | — | 🌎 NA |
- As an induction agent: 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an induction agent | 1 mg/kg IV plus diazepam 0.5 mg/kg IV | IV | Once | — | 🌎 NA |
| As an induction agent | 1-2 mg/kg rapidly IV | IV | Once | — | 🌎 NA |
| As an induction agent | 0.5-2 mg/kg IV | IV | Once | — | 🌎 NA |
- As an induction agent: 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.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an induction agent in the cardiovascular unstable patient (Rabbits) | 1-2 mg/kg IV after diazepam (0.5 mg/kg IV) | IV | Once | — | 🌎 NA |
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| As an induction agent in the cardiovascular unstable patient | 1-2 mg/kg IV after diazepam (0.5 mg/kg IV) | IV | Once | — | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
依託咪酯是一種短效的注射型非巴比妥類麻醉誘導劑。在獸醫學中，它以心血管穩定性著稱，對於患有心臟功能障礙、頭部外傷或重症的病患，它是硫噴妥鈉 (thiopental) 或異丙酚 (propofol) 的優良替代品。
臨床重點：
- 血流動力學穩定： 對心率和血壓的影響極小，非常適合心臟病或休克病患。
- 神經學益處： 可降低腦血流、腦耗氧量及顱內壓，對頭部外傷病患有益。
- 內分泌影響： 會抑制皮質醇 (cortisol) 的產生，重症病患可能需要補充皮質類固醇。
- 無鎮痛作用： 僅提供催眠與失憶效果，必須合併使用適當的鎮痛藥物。
作用機制
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.
安全性與警告
禁忌症
- Known hypersensitivity to etomidate
- Maintenance of anesthesia (due to cumulative adrenal suppression)
- Use as a sole agent for painful procedures (lacks analgesia)
不良反應
- 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)
注意事項
Adrenocortical Suppression: Etomidate inhibits cortisol production. It should only be used for induction, not maintenance. Use with extreme caution in patients with impaired adrenocortical function. Exogenous glucocorticoids (e.g., dexamethasone) should be considered in severely compromised animals.
- Hepatic/Renal Impairment: Elimination half-lives may be significantly increased. The propylene glycol carrier may be problematic in patients with liver dysfunction.
- Hemolysis & Pain: Injecting into a running IV line is recommended to decrease pain on injection and potentially reduce hemolysis caused by the propylene glycol vehicle.
- Premedication: Administering a benzodiazepine (diazepam, midazolam) or opiate prior to etomidate can minimize myoclonus, vomiting, and potential seizure-like activity.
藥物相互作用
Additive pharmacological effects; can increase CNS or respiratory depression.
Associated with potentiating the anesthetic and respiratory depressant effects of etomidate.
監測
- Level of consciousness
- Respiration rate and depth
- Cardiovascular function (blood pressure, heart rate, ECG)
藥物動力學
吸收
After intravenous injection, etomidate is rapidly distributed into the CNS.
分佈
Rapidly cleared from the brain back into systemic tissues. Duration of hypnosis is short (3-5 minutes) and dose-dependent. 75% bound to plasma proteins.
代謝
Rapidly metabolized in the liver primarily via hydrolysis or glucuronidation to inactive metabolites.
排除
The majority of the drug and metabolites are excreted into the urine, with the remainder into the bile and feces. Elimination half-life ranges from 1.25-5 hours in humans.
過量
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.
可用產品
劑型
- Injection: 2 mg/mL
人用標示
- Etomidate Injection: 2 mg/mL in 10 mL & 20 mL single-dose vials, 10 mL & 20 mL amps and 20 mL Abboject syringes; Amidate® (Hospira); generic
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Unless otherwise labeled, store etomidate injection at room temperature and protect from light.
飼主須知
依託咪酯是一種強效的鎮靜催眠麻醉劑。
- 僅限專業使用： 僅限由獸醫專業人員在具備完善病患監測設備（如心電圖、血壓、血氧監測）的臨床環境中使用。
- 使用原因： 如果您的寵物患有心臟疾病、頭部外傷或屬於重症，獸醫可能會選擇這種特定的麻醉劑，因為它對心血管系統的影響比其他麻醉劑溫和得多。
- 預期情況： 它用於在手術前安全地引導寵物進入睡眠狀態。由於它本身不具備止痛效果，您的寵物將會根據需要接受額外的止痛藥物。
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