Induction agent that may cause adrenal cortex suppression is -

Ans. is 'b' i.e., Etomidate Etomidateo It has a briefer duration of action 4-8 minutes.o It produces little cardiovascular and respiratory depression - Agent of choice for cardiovascular surgeries (bypass, aneurysms, valve surgery).o Coronary perfusion pressure is maintained when it is used with fentanyl.o Etomidate tends to reduce increased ICP - etomidate should be considered when maintenance of cerebral perfusion is important.o Etomidate has the highest incidence of nausea and vomiting amonst inducing agents 30%-40%.o It can produce hiccups and myoclonus.o Superficial thrombophlebitis and pain on injection may occur - Pain can be reduced by using larger vein and injecting lidocaine just before etomidate.o Intraarterial injection is not associated with local or vascular complications.o The specific endocrine effects manifested by etomidate are a dose dependent reversible inhibition of enzyme 11-b-hydroxylase, which coverts 11-deoxycortisol to cortisol and a relative minor effect on 17a - hydroxylase.o There is decreased synthesis of adrenal corticoids with increase in precursors 11-deoxycortisol and 17- hydroxyprogesterone.o ACTH secretion increases due to loss of feed back inhibition.o Vit 'C'supplementation restores cortisol levels to normal after use of etomidate.