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Etomidate (Molecule of the Month for June 2007)

Etomidate is a short acting intravenous anaesthetic agent used for the induction of general anaesthesia and for sedation for short procedures such as reduction of dislocated joints and cardioversion. It was discovered at Janssen Pharmaceutica in 1964. Etomidate has anesthetic and amnestic properties, but has no analgesic properties.

Etomidate is commonly used in the emergency setting as part of a rapid sequence induction to induce anesthesia or for conscious sedation. It is often used in this setting since it has a rapid onset of action and a low cardiovascular risk profile, and therefore is less likely to cause a significant drop in blood pressure than other induction agents. In the operating room with a stable patient, anesthesiologists may choose an alternative induction agent, such as propofol, thiopental or methohexital.

Etomidate is available as a clear colourless solution for injection containing 2 mg/ml of etomidate in an aqueous solution of 35% propylene glycol, although a lipid emulsion preparation (of equivalent strength) has also been introduced. Etomidate is presented as a racemic mixture, but only the D-isomer has pharmacological activity.

Formal Chemical Name (IUPAC)
(R)-ethyl 1-(1-phenylethyl)-1H-imidazole-5-carboxylate



Picture of Etomidate

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Etomidate structure
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Picture of Etomidate

C14 H16 N2 O2

Update by Karl Harrison
(Molecule of the Month for June 2007 )