The inhibition by etomidate of the 11 beta-hydroxylation of cortisol.
The effect of a sleep-dose of etomidate on the plasma concentrations of cortisol, 11-deoxycortisol and 17 alpha OH-progesterone was investigated in eight patients; two other patients received thiopentone. Blood samples were collected at 0, 15 and 30 min after etomidate or thiopentone when an injection of tetracosactrin was given and a final sample was collected at 60 min. The plasma cortisol response to tetracosactrin was depressed below normal in patients given etomidate, and the 11-deoxycortisol response was very high, ranging from 36.4 to 184.7 nmol/l. The two patients that received thiopentone had a normal response to all steroids. The identity of the plasma 11-deoxycortisol in two patients was confirmed by high-performance liquid chromatographic separation and quantification by both spectrophotometric and radioimmunoassay measurements. These results suggest that a single dose of etomidate inhibits 11 beta-hydroxylation of cortisol.
D015065:17-Hydroxycorticosteroids / Q000097:blood*; D019326:17-alpha-Hydroxyprogesterone; D000302:Adrenal Cortex / Q000187:drug effects*; D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D003350:Cortodoxone / Q000097:blood*; D003366:Cosyntropin / Q000494:pharmacology; D005045:Etomidate / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D006900:Hydroxylation; D006908:Hydroxyprogesterones / Q000097:blood*; D007093:Imidazoles / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013874:Thiopental / Q000627:therapeutic use
D015065:17-Hydroxycorticosteroids; D006908:Hydroxyprogesterones; D007093:Imidazoles; D003366:Cosyntropin; D019326:17-alpha-Hydroxyprogesterone; D013874:Thiopental; D003350:Cortodoxone; D006854:Hydrocortisone; D005045:Etomidate