Induction agent that may cause adrenal coex suppression is

The specific endocrine effects manifested by etomidate consist of a dose-dependent reversible inhibition of the enzyme 11b-hydroxylase, which results in decreased biosynthesis of coisol. Blockade of the cytochrome P450-dependent enzyme 11b-hydroxylase also results in decreased mineralocoicoid production and increased formation of intermediaries (11-deoxycoicosterone). Subsequent research has shown that etomidate is far more potent as an inhibitor of steroid synthesis than as a sedative-hypnotic agent. The etomidate concentrations associated with adrenocoical suppression are less than 10 ng/mL, which are much lower than the concentrations needed for hypnosis (>200 ng/mL). Ref: Miller's anesthesia 8th edition