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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A key...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...

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Related Experiment Video

Updated: Jun 28, 2026

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat
12:41

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat

Published on: August 28, 2021

[Should etomidate still be used?].

J-F Payen1, M Vinclair, C Broux

  • 1Pôle d'anesthésie-réanimation, hôpital Michallon, BP 217, 38043 Grenoble, France. jfpayen@ujf-grenoble.fr

Annales Francaises D'Anesthesie Et De Reanimation
|November 5, 2008
PubMed
Summary
This summary is machine-generated.

Etomidate inhibits cortisol synthesis by blocking 11 beta-hydroxylase, causing adrenal insufficiency. Diagnostic criteria for drug-induced adrenal impairment require elevated 11 beta-deoxycortisol and low cortisol, which are rarely met.

Related Experiment Videos

Last Updated: Jun 28, 2026

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat
12:41

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat

Published on: August 28, 2021

Area of Science:

  • Anesthesiology
  • Endocrinology
  • Critical Care Medicine

Background:

  • Etomidate is an anesthetic agent known to inhibit cortisol synthesis by blocking 11 beta-hydroxylase.
  • This inhibition can lead to primary adrenal insufficiency, characterized by elevated 11 beta-deoxycortisol and suppressed cortisol levels.
  • Accurate diagnosis of etomidate-induced adrenal impairment is challenging due to uncommonly met diagnostic criteria.

Purpose of the Study:

  • To review the diagnostic criteria for etomidate-induced adrenal insufficiency.
  • To discuss the implications of etomidate use in critically ill patients, including those with sepsis and traumatic brain injury.
  • To evaluate the potential need for hydrocortisone substitution after etomidate administration.

Main Methods:

  • Literature review of studies investigating etomidate's effects on adrenal function.
  • Analysis of diagnostic criteria for drug-induced adrenal insufficiency.
  • Discussion of clinical scenarios involving etomidate administration in critically ill patients.

Main Results:

  • Etomidate's inhibition of 11 beta-hydroxylase leads to adrenal insufficiency, but diagnostic criteria are infrequently satisfied.
  • A single dose of etomidate causes reversible adrenal inhibition in non-septic critically ill patients within 48 hours.
  • Avoiding etomidate in severe sepsis and septic shock is recommended, while its use for tracheal intubation in traumatic brain injury may prevent hypotension.

Conclusions:

  • Strict diagnostic criteria for etomidate-induced adrenal insufficiency are rarely met.
  • While etomidate's impact on mortality is uncertain, its use in severe sepsis/septic shock should be reconsidered.
  • Hydrocortisone substitution may be warranted after single-dose etomidate in critically ill patients.