Comparative Pharmacology
Head-to-head clinical analysis: AMIDATE versus KETAMINE HCL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMIDATE versus KETAMINE HCL.
AMIDATE vs KETAMINE HCL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
AMIDATE (etomidate) is a nonbarbiturate hypnotic agent that acts as a positive allosteric modulator of the GABA-A receptor at the beta-2/3 subunit, enhancing the inhibitory effects of GABA and producing rapid sedation and anesthesia.
Noncompetitive NMDA receptor antagonist; blocks glutamate binding, and modulates opioid receptors, monoaminergic receptors, and voltage-gated calcium channels.
0.2-0.6 mg/kg IV bolus for induction of anesthesia.
Induction: 1-2 mg/kg IV; Maintenance: 0.5-1 mg/kg IV or 10-30 mcg/kg/min IV infusion; Subanesthetic: 0.1-0.5 mg/kg IV; Analgesic: IM 2-4 mg/kg; Intranasal 1-3 mg/kg. Frequency: single doses or continuous infusion per clinical need.
None Documented
None Documented
Terminal elimination half-life: 2.5–4 hours (adults); 1–2 hours (children); Prolonged in hepatic impairment or with continuous infusion.
Terminal elimination half-life: 2–4 hours (alpha: 10–15 min, beta: 2.5–4 hr); prolonged in hepatic impairment and with repeated dosing (up to 12–24 hr for active metabolite norketamine).
Renal: <5% unchanged; Hepatic metabolism to carboxylic acid metabolite (inactive); Metabolite renally eliminated; Fecal: negligible.
Renal: 90% as metabolites (norketamine, dehydronorketamine, hydroxylated derivatives) and 4% unchanged; biliary/fecal: 3%; minor pulmonary exhalation.
Category C
Category C
General Anesthetic
General Anesthetic