This review focuses on the unique clinical and molecular pharmacologic features of
etomidate. Among general anesthesia induction drugs, etomidate is the only imidazole, and
it has the most favorable therapeutic index for single-bolus administration. It also produces a
unique toxicity among anesthetic drugs: inhibition of adrenal steroid synthesis that far
outlasts its hypnotic action and that may reduce survival of critically ill patients. The major
molecular targets mediating anesthetic effects of etomidate in the central nervous system are …