Category: etomidate

Journal Watch: Anesthesia Drugs of the Future

Am excellent review article appears in this months British Journal of Anesthesia entitled “New Drugs and Technologies, Intravenous Anaesthesia is on the Move (Again)”. Its an excellent summary of the drugs we have, whats wrong with them and what is in development.

I’ve previously mentioned some of the drugs in the article like MOC-Etmoidate and fospropofol. I have since had the (dis)pleasure of using the latter with some interesting results…painful rectal itching and/or burning(!). Severe enough to make my never touch the stuff again. The mechanism is unclear at this time and I’m not sure I really care.

The benzo and propofol reformulations seem to have little advantage in my humble opinion.  My money is on one of the etomidate analogues to replace propofol as the one induction agent to rule all induction agents.  Article also contains an interesting discussion on the financial aspects of the drug development process.  Enjoy.

Sep 14, 2010 | 0 comments View Post

Etomidate-the remix

Wouldn’t it be great of propofol had all the favorable pharmacokinetics we’ve all grown to know and love, without the sphincter-clenching cardiorespiratory side effects? MOC-Etomidate may be the answer.

Etomidate has generally fallen out of favor these last few years out of concern for prolonged adrenal suppression, sometimes just after one dose. Researchers at MGH seem to have found an answer as published in this months Anesthesiology:
According to Dr. Raines, MOC-etomidate is a “soft analogue” of etomidate, meaning that it is a derivative of a parent drug specifically designed to undergo fast and predictable metabolism after its beneficial effects have taken place in the body.
Etomidate is an intravenous general anesthetic used to induce anesthesia at the start of surgery. It is distinguished from other anesthetics in that it has minimal effects on breathing and cardiovascular function.
But etomidate cannot be used to maintain anesthesia during surgery because it produces very prolonged and potentially dangerous suppression of the body’s adrenal glands, said Dr. Raines.
MOC-etomidate, on the other hand, was shown in laboratory and animal studies to act upon the body for only a very short time period, to be quickly metabolized, and to provide faster recovery from anesthesia, all while producing no significant effects on the adrenal glands within minutes after administration.
We’ll have to wait some time for clinical trials on live intact humans (unless your practice involves tadpoles), but in the meantime propfol it is.

Aug 04, 2009 | 0 comments View Post