Effect of etomidate on cortisol biosynthesis: site of action after induction of anaesthesia
| Autor: | R. De Coster, J. H.J. H. Helmers, H. Noorduin |
|---|---|
| Rok vydání: | 1985 |
| Předmět: |
Adult
endocrine system medicine.medical_specialty Hydrocortisone Endocrinology Diabetes and Metabolism Cortodoxone Adrenocorticotropic hormone Random Allocation chemistry.chemical_compound Endocrinology Adrenocorticotropic Hormone Etomidate Internal medicine Adrenal Glands Hydroxyprogesterones medicine Humans Thiopental Cortisol biosynthesis Aldosterone Aged Clinical Trials as Topic business.industry 17-alpha-Hydroxyprogesterone General Medicine Middle Aged chemistry Mechanism of action Anesthesia Anesthesia Intravenous Female Onset of action medicine.symptom business medicine.drug |
| Zdroj: | Acta Endocrinologica. 110:526-531 |
| ISSN: | 1479-683X 0804-4643 |
| DOI: | 10.1530/acta.0.1100526 |
| Popis: | To determine the site of inhibition of etomidate on cortisol biosynthesis, plasma cortisol, aldosterone, 17α-hydroxyprogesterone, 11-deoxycortisol and ACTH levels were measured in healthy women before and after the administration of a single dose of either 0.20 mg kg−1 etomidate (mean value, n = 10) or 3.15 mg kg−1 thiopental (n = 9) for induction of anaesthesia in a randomized trial. Etomidate produced a smaller increase in plasma cortisol and had a later onset of action than thiopental. Plasma ACTH levels, however, rose higher in the etomidate-induced patients to reach peak levels 6 h after drug administration. In the same group, plasma aldosterone remained below the control levels but still within the normal range, whereas it rose about 2-fold in the thiopental group. Plasma levels of 17α-hydroxyprogesterone and 11β-deoxycortisol were hardly modified after thiopental but increased significantly and remained high for 6 h after etomidate injection. This marked rise in precursors together with a blunted and delayed cortisol response to high ACTH levels, and slightly lowered plasma aldosterone concentration indicates a blockage of 1 1β-hydroxylation in adrenal cortisol synthesis after induction of anaesthesia with etomidate. |
| Databáze: | OpenAIRE |
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