• Etomidate is one of the few anesthetics that suppresses the adrenocortical axis. Etomidate causes adrenocortical suppression by producing a dose-dependent inhibition of the enzyme 11-beta-hydroxylase which is necessary for conversion of cholesterol to cortisol. This suppression lasts 4 to 8 hours after an induction dose of etomidate.
  • Etomidate maintains hemodynamic stability and has little effect on the heart. Etomindate causes adrenal suppression and steroid administration may be necessary in patients already having adrenal axis suppression.