title: Etomidate in the management of hypercortisolaemia in Cushing's syndrome: a review.
abstract: This review addresses the practical usage of intravenous etomidate as a medical therapy in Cushing's syndrome. We reviewed the relevant literature, using search terms 'etomidate', 'Cushing's syndrome', 'adrenocortical hyperfunction', 'drug therapy' and 'hypercortisolaemia' in a series of public databases. There is a paucity of large randomised controlled trials, and data on its use rely only on small series, case study reports and international consensus guideline recommendations. Based on these, etomidate is an effective parenteral medication for the management of endogenous hypercortisolaemia, particularly in cases with significant biochemical disturbance, sepsis and other serious complications such as severe psychosis, as well as in preoperative instability. We suggest treatment protocols for the safe and effective use of etomidate in Cushing's syndrome.
authors.affiliation: Department of Endocrinology, Oxford Centre for Diabetes Endocrine and Metabolism, Churchill Hospital, Oxford OX3 7LJ, UK.
authors.forename: Veronica A
authors.initials: VA
authors.lastname: Preda
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sen
authors.forename: Niki
authors.initials: N
authors.lastname: Karavitaki
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Grossman
mesh_terms: D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D003480:Cushing Syndrome / Q000188:drug therapy* / Q000453:epidemiology; D005045:Etomidate / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D006854:Hydrocortisone; D005045:Etomidate