Adrenal suppression is a side effect of:-: (A) Thiopentone sodium, (B) Ketamine, (C) Propofol, (D) Etomidate
Answer is D. Etomidate inhibits 11-beta hydroxylase enzyme in adrenal coex. ETOMIDATE Etomidate is a carboxylated imidazole - containing anesthetic compound structurally unrelated to any other IV anesthetics. Aqueous solution of etomidate is unstable at physiologic pH and a formulated in a 0.2% solution with 35% prophylene glycol. IV injection causes pain on injection, veno irritation and hemolysis. CNS - Decreases CMRO2, CBF and ICP Cerebroprotective Decreases EEG activity CVS - Minimal cardiorespiratory depression even in the presence of cardiovascular and pulmonary disease. No histamine release. R.S - Respiratory depression Blunts hypoxic / hypercapnic drive Bronchodilator Hepatic / Renal - Side Effects 1. Adrenal coex suppression Etomidate inhibits the activity of 11- B hydroxyl- lase, an enzyme necessary for the synthesis of coisol, aldosterone, 17 - hydroxyl - progesterone and coicosterone. 2. Pain on injection 3. High incidence of postoperative nausea and vomiting 4. Myoclonic activity 5. Inhibit platelet function Uses:- Induction agent of choice for poor- risk