Anaes SAQs · Intravenous induction agents
The pharmacology of etomidate
The etomidate — the GABA-A beta-2/beta-3 positive allosteric modulator; the imidazole in the propylene glycol (the pain); the haemodynamically NEUTRAL (no change in HR/BP/CO/SVR); the 11-beta-hydroxylase and the cholesterol side-chain cleavage inhibition (the cortisol and the aldosterone block; the 8 to 24 hours); pooled RCTs (no mortality difference vs ketamine); the dose 0.2 to 0.3 mg/kg.
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Prompt
Outline the pharmacology of etomidate, with particular reference to its cardiovascular effects, the mechanism and duration of its adrenal suppression, and its place in the rapid-sequence induction of the septic patient.
Question
Outline the pharmacology of etomidate, with particular reference to its cardiovascular effects, the mechanism and duration of its adrenal suppression, and its place in the rapid-sequence induction of the septic patient.
[8]References5ShowHide
- [1]Andriazzi VH, et al. Etomidate versus ketamine for emergency intubation. J Intensive Care Med, 2026.PMID 42299661
- [2]Zampieri FG, et al. Induction agents for emergency tracheal intubation. Crit Care, 2026.PMID 42121165
- [4]Bhattacharya O, et al. Normalization of Potassium Despite 11-Deoxycorticosterone Rise During Etomidate Therapy in Adrenocortical Carcinoma. JCEM Case Rep, 2026.PMID 41940234
- [8]Cao Y, et al. Comparison of EEG Burst Suppression and Hemodynamic Effects Between Remimazolam Tosilate and Etomidate During General Anesthesia Induction: A Retrospective Analysis. Drug Des Devel Ther, 2025.PMID 40927073
- [5]Cherfan AJ, Arabi YM, Al-Dorzi HM, et al. Advantages and disadvantages of etomidate use for intubation of patients with sepsis Pharmacotherapy, 2012.PMID 22488264