Possible Interaction: Epinephrine and Etomidate

“This marked rise in precursors together with a blunted and delayed cortisol response to high ACTH levels, and slightly lowered plasma aldosterone concentration indicates a blockage of 11 beta-hydroxylation in adrenal cortisol synthesis after induction of anaesthesia with etomidate.”

“These results lead to the conclusion that etomidate inhibits adrenal 11 beta-hydroxylation.”

“4 They both conclude that single-dose etomidate is associated with transient suppression of the adrenal axis.”

“Recent retrospective studies in the pediatric and adult intensive care literature have shown an association between a single induction dose of etomidate in critically ill septic patients and sustained suppression of the adrenal axis with an increase in mortality.”

“Kenyon C J, Young J, Gray CE, Fraser R (1984) Inhibition by etomidate of ster0idogenesis in isolated bovine adrenal cells.”

“At a concentration of 100 nM, etomidate inhibited the adrenal 11-hydroxylation of glucocorticoid and mineralocorticoid biosyntheses, producing a decrease in cortisol and corticosterone and an accumulation of 11-deoxycortisol and 11-deoxycorticosterone in guinea-pig adrenal and rat capsular adrenal cell suspensions, respectively.”

“ii) What is the mechanism by which etomidate is thought to affect the adrenal axis? (”