TAILIEUCHUNG - Handbook of Pediatric Cardiovascular Drugs - part 9

Bệnh Lý điều kiện ảnh hưởng đến kết quả gan trong giải phóng mặt bằng giảm etomidate và một kéo dài và phóng đại effect14 Nhanh chóng phục hồi từ các tác dụng an thần của etomidate là một kết quả của việc tái phân phối lớn, giải phóng mặt bằng trao đổi chất cao. | 286 . Yang P. Taneja and PJ. Davis Pathological conditions affecting the liver result in decreased clearance of etomidate and a prolonged and exaggerated effect14 Rapid recovery from the sedative effects of etomidate is a result of both large redistribution and high metabolic clearance. Drug-Drug Interactions Etomidate injection is compatible with the commonly administered preanesthetic medications Etomidate hypnosis does not significantly alter the usual dosage requirements of depolarizing or nondepolarizing neuromuscular blocking agents Narcotics like fentanyl may decrease the elimination of etomidate Verapamil may increase the anesthetic and respiratory depressant effects of etomidate Long-term infusion is likely to result in inhibition of adrenal steroid synthesis with decreased levels of cortisol and aldosterone Systemic and Adverse Effects Etomidate has also been associated with some adverse effects when used for induction. Gastrointestinal Potential gastrointestinal effects of etomidate are nausea and vomiting the most frequent in approximately 30-40 of patients . Use of opioids along with etomidate worsens this complaint. Cardiovascular Cardiovascular effects of etomidate need special consideration because this drug is highly recommended to be used during induction of anesthesia in patients with little or no cardiac reserve. Etomidate has minimal effects on cardiovascular function. An induction dose of mg kg of etomidate causes less than 10 change in heart rate mean arterial pressure MAP mean pulmonary artery pressure PAP pulmonary capillary wedge pressure PCWP central venous pressure CVP CI stroke volume and pulmonary and systemic vascular These effects of cardiovascular stability are also observed in patients with coronary heart disease valvular heart disease cardiomyopathy and in patients with cardiac disease undergoing noncardiac surgery. The hemodynamic stability seen with etomidate is probably caused by its lack of effect on both

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