Home Drug Guide Ethinamate

Drug Guide

Generic Name

Ethinamate

Brand Names Valmid

Classification

Therapeutic: Anxiolytic, Sedative

Pharmacological: Barbiturate, GABA-A receptor agonist

FDA Approved Indications

Sedation prior to medical procedures

Mechanism of Action

Enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptors, leading to increased chlorid ion influx and neuronal hyperpolarization, producing sedative and anxiolytic effects.

Dosage and Administration

Adult: Typically 200-400 mg orally at bedtime or divided doses. Exact dosing varies based on clinical response.

Pediatric: Use is generally not recommended due to safety concerns.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dose accordingly, as clearance may be reduced.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Rapidly absorbed orally.

Distribution: Widely distributed throughout body tissues; crosses the blood-brain barrier.

Metabolism: Metabolized primarily in the liver.

Excretion: Excreted mainly via the kidneys as metabolites.

Half Life: Approximately 4-6 hours.

Contraindications

Hypersensitivity to barbiturates
Porphyria

Precautions

History of drug dependence
Respiratory depression
Pregnancy category D; can cause fetal harm

Adverse Reactions - Common

Drowsiness (Common)
Dizziness (Common)
Nausea (Less common)

Adverse Reactions - Serious

Respiratory depression (Rare)
Hypersensitivity reactions (Rare)
Dependence and withdrawal issues (Potential with prolonged use)

Drug-Drug Interactions

Other CNS depressants (e.g., benzodiazepines, opioids)

Drug-Food Interactions

Alcohol

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor sedative effects, respiratory status, and signs of dependence.

Diagnoses:

Risk for respiratory depression
Risk for substance dependence

Implementation: Administer with caution, monitor patient responses, and educate about sedation effects.

Evaluation: Assess efficacy and monitor for adverse effects.

Patient/Family Teaching

Avoid alcohol and other CNS depressants.
Do not operate heavy machinery until effects are known.
Report any signs of allergic reactions or unusual sedation.

Special Considerations

Black Box Warnings:

Significant risk of respiratory depression leading to death, especially when combined with other CNS depressants.
Risk of dependence and withdrawal.
Use only for short-term treatment.

Genetic Factors: None specifically identified.

Lab Test Interference: May alter liver function tests.

Overdose Management

Signs/Symptoms: Profound sedation, respiratory depression, coma, hypotension.

Treatment: Supportive care, airway management, oxygen therapy, and possibly dialysis; activated charcoal if ingestion is recent.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable when stored properly.