Literature DB >> 14508322

Activation of alpha 2B-adrenoceptors mediates the cardiovascular effects of etomidate.

Andrea Paris1, Melanie Philipp, Peter H Tonner, Markus Steinfath, Martin Lohse, Jens Scholz, Lutz Hein.   

Abstract

BACKGROUND: The intravenous anesthetic etomidate exhibits structural similarities to specific alpha2-adrenoceptor agonists of the type such as dexmedetomidine. The current study was performed to elucidate the possible interaction of etomidate with alpha2-adrenoceptors in mice lacking individual alpha2-adrenoceptor subtypes (alpha2-KO).
METHODS: Sedative and cardiovascular responses to etomidate and the alpha2-agonist, dexmedetomidine, were determined in mice deficient in alpha2-receptor subtypes. Inhibition of binding of the alpha2-receptor antagonist [3H]RX821002 to recombinant alpha2-receptors by etomidate was tested in human embryonic kidney (HEK293) cells in vitro.
RESULTS: In vivo, loss and recovery of the righting reflex required similar times after intraperitoneal injection of etomidate in wild-type and in alpha2A-receptor-deficient mice, indicating that the hypnotic effect of etomidate in mice does not require the alpha2A-receptor subtype. Intravenous injection of etomidate resulted in a transient increase (duration 2.4 +/- 0.2 min) in arterial blood pressure in wild-type mice (17 +/- 3 mmHg). Etomidate did not affect blood pressure in alpha2B-KO or alpha2AB-KO mice. In membranes from HEK293 cells transfected with alpha2-receptors, etomidate inhibited binding of the alpha2-antagonist, [3H]RX821002, with higher potency from alpha2B- and alpha2C-receptors than from alpha2A-receptors (Ki alpha2A 208 microm, alpha2B 26 microm, alpha2C 56 microm). In alpha2B-receptor-expressing HEK293 cells, etomidate rapidly increased phosphorylation of the extracellular signal-related kinases ERK1/2.
CONCLUSIONS: These results indicate that etomidate acts as an agonist at alpha2-adrenoceptors, which appears in vivo primarily as an alpha2B-receptor-mediated increase in blood pressure. This effect of etomidate may contribute to the cardiovascular stability of patients after induction of anesthesia with etomidate.

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Year:  2003        PMID: 14508322     DOI: 10.1097/00000542-200310000-00022

Source DB:  PubMed          Journal:  Anesthesiology        ISSN: 0003-3022            Impact factor:   7.892


  20 in total

Review 1.  Molecular approaches to improving general anesthetics.

Authors:  Stuart A Forman
Journal:  Anesthesiol Clin       Date:  2010-12

Review 2.  [Strategies for perioperative sympatho-modulation].

Authors:  J Wacker; T Pasch; M C Schaub; M Zaugg
Journal:  Anaesthesist       Date:  2005-04       Impact factor: 1.041

3.  ICU physicians should abandon the use of etomidate!

Authors:  Djillali Annane
Journal:  Intensive Care Med       Date:  2005-01-27       Impact factor: 17.440

Review 4.  [The GABA(A) receptor family: possibilities for the development of better anesthetics].

Authors:  B Drexler; C Grasshoff; U Rudolph; K Unertl; B Antkowiak
Journal:  Anaesthesist       Date:  2006-03       Impact factor: 1.041

Review 5.  Clinical and molecular pharmacology of etomidate.

Authors:  Stuart A Forman
Journal:  Anesthesiology       Date:  2011-03       Impact factor: 7.892

Review 6.  [Etomidate for intravenous induction of anaesthesia].

Authors:  C Dumps; D Bolkenius; E Halbeck
Journal:  Anaesthesist       Date:  2017-12       Impact factor: 1.041

Review 7.  Medical suppression of hypercortisolemia in Cushing's syndrome with particular consideration of etomidate.

Authors:  Jens Heyn; Carolin Geiger; Christian L Hinske; Josef Briegel; Florian Weis
Journal:  Pituitary       Date:  2012-06       Impact factor: 4.107

Review 8.  New insights into the molecular mechanisms of general anaesthetics.

Authors:  P-L Chau
Journal:  Br J Pharmacol       Date:  2010-09       Impact factor: 8.739

Review 9.  Pharmacological profiles of alpha 2 adrenergic receptor agonists identified using genetically altered mice and isobolographic analysis.

Authors:  Carolyn A Fairbanks; Laura S Stone; George L Wilcox
Journal:  Pharmacol Ther       Date:  2009-04-23       Impact factor: 12.310

Review 10.  [Aspiration syndrome: epidemiology, pathophysiology, and therapy].

Authors:  O Bartusch; M Finkl; U Jaschinski
Journal:  Anaesthesist       Date:  2008-05       Impact factor: 1.041

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