Figure 1. Adrenal aldosterone and cortisol biosynthetic pathways. Key steps have been labeled with the enzymes responsible for catalysis. Enzymes inhibited by etomidate have been demarcated by the blocked white arrowheads. Etomidate primarily inhibits 11β-hydroxylase, and exerts decreasing effects at 11β/18-hydroxylase & the cholesterol side-chain cleavage enzyme system, respectively.