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Novel Compound May Provide New Anesthetic Choice

MOC-etomidate has advantages of parent drug etomidate, but doesn't suppress adrenal glands

MONDAY, July 27 (HealthDay News) -- Methoxycarbonyl-etomidate (MOC-etomidate), a new compound derived from the anesthetic etomidate, is as fast-acting and provides the same hemodynamic stability as its parent drug, but does not cause dangerous adrenal gland suppression as etomidate can, according to a study in the August issue of Anesthesiology.

Joseph F. Cotten, M.D., of Massachusetts General Hospital in Boston, and colleagues determined the necessary concentration of the new compound and its anesthetic effects in tadpoles and rats, and used human liver cells in vitro to assess the drug's metabolism time in humans.

In the human liver cells, the researchers found that the MOC-etomidate had an in-vitro half-life of 4.4 minutes versus more than 40 minutes for etomidate, and produced carboxylic acid as its only detectable metabolite. In rats, MOC-etomidate caused a rapid and short-lived loss of righting reflex with minimal hemodynamic changes. Unlike etomidate, the authors note that there was no adrenocortical suppression discerned 30 minutes after administration of MOC-etomidate.

"MOC-etomidate is an etomidate analogue that retains etomidate's important favorable pharmacological properties. However, it is rapidly metabolized, ultra-short acting, and does not produce prolonged adrenocortical suppression following bolus administration," Cotton and colleagues conclude.

Massachusetts General Hospital has a patent application pending for MOC-etomidate and related analogues. Several of the study authors could gain financially with the development or sale of the compound.

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