What is a potential consequence of etomatide toxicity in elderly patients?

Etomide is an anesthetic agent that, while not commonly used in practice today, has particular pharmacological effects that can impact patients, especially in certain populations such as the elderly. One potential consequence of etomidate toxicity in elderly patients is severe adrenal insufficiency.

Etomidate is known to suppress adrenal steroidogenesis, leading to decreased production of cortisol. In elderly patients, who may already have compromised physiological reserve and less robust adrenal response due to aging, this suppression can become clinically significant. The rapid onset of adrenal insufficiency caused by etomidate toxicity can result in an inability to mount an adequate stress response, potentially leading to symptoms related to low cortisol levels such as hypotension, fatigue, and weakness.

This aspect highlights the importance of cautious use of etomidate in elderly patients, particularly in contexts where they may be at higher risk for adrenal insufficiency, such as during surgery or critical care situations where their physiological stress and need for adrenal response is heightened.