Cosyntropin
Adrenal Insufficiency
Post-Dural Puncture Headache
Adrenal Cortex Function Tests
Addison Disease
Hydrocortisone
Spinal Puncture
Adrenal Glands
Drug Information Services
Anti-Infective Agents
Pamphlets
Microbial Sensitivity Tests
Drug Labeling
On the meaning of low-dose ACTH(1-24) tests to assess functionality of the hypothalamic-pituitary-adrenal axis. (1/142)
To analyse further the ACTH(1-24) low-dose test, which is of clinical interest, we have examined the dose-response relationship between plasma ACTH(1-24) and cortisol concentrations after i.v. administration of increasing doses (1, 5 or 250 microg) of ACTH(1-24) as a bolus. In addition, we have measured plasma ACTH(1-39) and cortisol levels after an insulin tolerance test (ITT). Although there was a dose response relationship between plasma ACTH(1-24) immunoreactivity and the dose injected, cortisol peaks were comparable, but lower than those reached after an ITT. Under these experimental conditions, an increase in plasma ACTH as low as 13 pmol/l (i.e. the increase obtained with the 1 microg dose) induced a near maximal cortisol response. Following injection of 1 microg ACTH(1-24), peak ACTH values were short lasting, similar to physiological daily bursts. After injection of 5 microg ACTH(1-24), plasma ACTH concentrations were higher than those reached during an ITT, but clearly shorter lasting. Injection of 250 microg ACTH(1-24) induced strikingly supraphysiological levels of plasma ACTH. We conclude that neither regular nor low-dose ACTH tests can fully reproduce the ITT. Our observations strongly suggest that the low-dose ACTH(1-24) test (1 microg) can be useful to estimate the adrenal sensitivity under basal, physiological conditions. (+info)Tests of adrenal insufficiency. (2/142)
AIM: In suspected adrenal insufficiency, the ideal test for assessing the hypothalamo-pituitary-adrenal axis is controversial. Therefore, three tests were compared in patients presenting with symptoms suggestive of adrenal insufficiency. METHOD: Responses to the standard short Synacthen test (SSST), the low dose Synacthen test (LDST), and the 08:00 hour serum cortisol concentration were measured in 32 patients. A normal response to the synacthen test was defined as a peak serum cortisol of >/= 500 nmol/l and/or incremental concentration of >/= 200 nmol/l. The sensitivity and specificity of the 08:00 hour serum cortisol concentration compared with other tests was calculated. RESULTS: Three patients had neither an adequate peak nor increment after the SSST and LDST. All had a serum 08:00 hour cortisol concentration of < 200 nmol/l. Eight patients had abnormal responses by both criteria to the LDST but had normal responses to the SSST. Three reported amelioration of their symptoms on hydrocortisone replacement. Twenty one patients had a normal response to both tests (of these, 14 achieved adequate peak and increment after both tests and seven did not have an adequate peak after the LDST but had a normal increment). The lowest 08:00 hour serum cortisol concentration above which patients achieved normal responses to both the LDST and SSST was 500 nmol/l. At this cut off value (compared with the LDST), the serum 08:00 hour cortisol concentration had a sensitivity of 100% but specificity was only 33%. CONCLUSION: The LDST revealed mild degrees of adrenal insufficiency not detected by the SSST. The value of a single 08:00 hour serum cortisol concentration is limited. (+info)Regression of cardiac abnormalities after replacement therapy in Addison's disease. (3/142)
OBJECTIVE: To evaluate by echocardiography the cardiac structure and function in patients with primary adrenocortical insufficiency. DESIGN AND METHODS: Two-dimensionally guided M-mode echocardiograms and spectral Doppler studies were performed in seven consecutive patients with newly diagnosed autoimmune primary adrenal failure before and 4-8 months after an adequate regimen of steroid substitution. Echocardiographic parameters were also studied in ten healthy controls. RESULTS: In the cases with untreated Addison's disease, both left ventricular end-systolic and end-diastolic dimensions were significantly reduced in comparison with those in controls (P<0.01). Four patients had echocardiographic signs of mitral valve prolapse (MVP) at the anterior leaflet, with no evidence of mitral regurgitation by Doppler echocardiography. Systolic clicks characteristic of MVP were present on auscultation in two of these cases. Left ventricular chamber size normalized, i.e. significantly increased (P<0.01), and both echocardiographic and physical signs of MVP resolved after steroid substitution in all patients. All other echocardiographic indices were normal before and after treatment. CONCLUSIONS: Patients with untreated Addison's disease have cardiac abnormalities which regress after steroid substitution. A valvular-ventricular disproportion due to the hypovolemic state could explain these findings. (+info)Adrenocortical response profiles to corticotrophin-releasing hormone and adrenocorticotrophin challenge in the chronically catheterized adult guinea-pig. (4/142)
The guinea-pig has been used extensively to investigate adrenal steroidogenesis. However, very little is known about adrenocortical responses to corticotrophin-releasing hormone (CRH) and adrenocorticotrophin (ACTH) in this species, in vivo. In the present study, we have developed a stress-free sampling system, in the chronically catheterized adult guinea-pig, that has allowed us to investigate basal and activated adrenocortical activity. Indwelling carotid artery and jugular vein catheters were surgically implanted into female guinea-pigs (n = 5). Each animal was treated with vehicle, human CRH (0.2 or 2 microg kg-1) and ACTH1-24 (0.2 or 2 microg kg-1), and serial plasma samples removed for analysis of ACTH and cortisol concentrations by radioimmunoassay. There was no effect of serial sampling on pituitary-adrenocortical activity, indicating that the animals remain in an unstressed state. Basal plasma ACTH and cortisol concentrations were 703.9 +/- 24.5 pg ml-1 and 117.9 +/- 5.2 ng ml-1, respectively. Both CRH and ACTH significantly increased adrenocortical activity in a dose-dependent manner. ACTH (2 microg kg-1) was the most potent activator leading to plasma cortisol concentrations of 647 +/- 116 ng ml-1. In conclusion, we have shown that basal plasma cortisol concentrations in the guinea-pig are low compared to those obtained in previous studies by cardiac puncture or following decapitation. However, plasma ACTH concentrations are high compared to other species. We have also shown that human CRH and ACTH1-24 act as potent activators of the guinea-pig pituitary-adrenocortical axis, leading to response profiles consistent with mild cortisol resistance. (+info)Effect of adrenocorticotrophic hormone on sodium appetite in mice. (5/142)
A main vector of the effects of stress is secretion of corticotrophin releasing factor (CRF), adrenocorticotrophin (ACTH), and adrenal steroids. Systemic administration of ACTH (2.8 microgram/day sc) for 7 days in BALB/c mice caused a very large increase of voluntary intake of 0.3 M NaCl equivalent to turnover of total body sodium content each day. Intracerebroventricular infusion of ACTH (20 ng/day) had no effect. Intracerebroventricular infusion of ovine CRF (10 ng/h for 7 days) caused an increase of sodium intake. The large sodium appetite-stimulating effect of systemic ACTH was not influenced by concurrent systemic infusion of captopril (2 mg/day). Induction of stress by immobilization of mice on a running wheel caused an increase in Na appetite associated with a 50% decrease of thymus weight, indicative of corticosteroid effects. The present data suggest that stress and the hormone cascade initiated by stress evoke a large sodium appetite in mice, which may be an important survival mechanism in environmental conditions causing stress. (+info)Evidence that melanocortin 4 receptor mediates hemorrhagic shock reversal caused by melanocortin peptides. (6/142)
Melanocortin peptides are known to be extremely potent in causing the sustained reversal of different shock conditions, both in experimental animals and humans; the mechanism of action includes an essential brain loop. Three melanocortin receptor subtypes are expressed in brain tissue: MC(3), MC(4,) and MC(5) receptors. In a volume-controlled model of hemorrhagic shock in anesthetized rats, invariably causing the death of control animals within 30 min after saline injection, the i.v. bolus administration of the adrenocorticotropin fragment 1-24 (agonist at MC(4) and MC(5) receptors) at a dose of 160 microg/kg i.v. (54 nmol/kg) produced an almost complete and sustained restoration of cardiovascular and respiratory functions. An equimolar dose of gamma(1)-melanocyte stimulating hormone (selective agonist at MC(3) receptors) was completely ineffective. The selective antagonist at MC(4) receptors, HS014, although having no influence on cardiovascular and respiratory functions per se, dose-dependently prevented the antishock activity of adrenocorticotropin fragment 1-24, with the effect being complete either at the i.v. dose of 200 microg/kg or at the i.c.v. dose of 5 microg/rat (17-20 microg/kg). We concluded that the effect of melanocortin peptides in hemorrhagic shock is mediated by the MC(4) receptors in the brain. (+info)Effect of leptin on ACTH-stimulated secretion of cortisol in rhesus macaques and on human adrenal carcinoma cells. (7/142)
OBJECTIVE: Because glucocorticoids stimulate leptin release and, at least in vitro, leptin inhibits cortisol secretion, a feedback system between glucocorticoids and leptin has been proposed. However, in humans and non-human primates there are no in vivo studies to support any role for leptin in the control of the hypothalamic-pituitary-adrenal axis. In this study, we investigated the effect of leptin on (i) ACTH-stimulated secretion of cortisol in six male rhesus monkeys and (ii) basal and forskolin (FSK)-stimulated cortisol secretion by the human adrenal carcinoma cell H295R in vitro. DESIGN AND METHODS: In vivo studies: after suppression of endogenous ACTH with either dexamethasone (n=6) or a corticotropin-releasing factor (CRF) antagonist (d-Phe CRF(12-41)) (n=3), 1 microg bolus of human ACTH(1-24) was administered to stimulate adrenal cortisol release. Blood samples were collected every 15 min for 3 h. Leptin (1 mg) was infused over 4 h, starting 1 h before ACTH bolus. IN VITRO STUDIES: NCI-H295R cells were incubated for 6, 12, 24 and 48 h in the absence or presence of 20 micromol/l FSK in combination with leptin (100 ng/ml medium). Cortisol levels in serum and medium were measured by solid phase radioimmunoassay. RESULTS: Acute leptin infusion to rhesus monkeys did not change basal cortisol levels, peak cortisol levels after ACTH(1-24) or the area under the curve when compared with studies in which leptin was not given. FSK increased cortisol levels in medium at 24 and 48 h, but leptin did not change cortisol release in either control or FSK-stimulated cells. CONCLUSIONS: Short-term leptin infusion affected neither the cortisol response to ACTH in non-human primates in vivo nor cortisol release (basal or FSK stimulated) by H295R cells, in vitro. These data suggest that leptin may not be an acute regulator of primate adrenal cortisol secretion. (+info)Isolated corticotropin deficiency in chronic alcoholism. (8/142)
Three patients who chronically abused alcohol were found to be hyponatraemic with normal plasma potassium. The first had been admitted with confusion and weight loss, the second with hypotension and sepsis, and the third with confusion and hypoglycaemia-induced seizures. All three patients had a subnormal cortisol response in the short synacthen test; however, the plasma cortisol after three days of tetracosactrin administration was greater than 550 nmol/L. Baseline corticotropin levels were less than 10 pg/mL in all three. No structural lesions of the hypothalamo-pituitary tract were found and there was no evidence of other endocrinopathies. Glucocorticoid replacement therapy led to the resolution of hyponatraemia and hypoglycaemia, where present, and to clinical improvement. The two surviving patients remained hypocortisolaemic in the long term, without recurrence of hyponatraemia or hypoglycaemia. The features of isolated corticotropin deficiency are easily confused with other effects of chronic alcohol abuse. In alcoholic patients with unexplained hyponatraemia, hypoglycaemia or haemodynamic instability, a short tetracosactrin test is advisable. (+info)Cosyntropin is a synthetic form of adrenocorticotropic hormone (ACTH) that is used in medical testing to assess the function of the adrenal glands. ACTH is a hormone produced and released by the pituitary gland that stimulates the production and release of cortisol, a steroid hormone produced by the adrenal glands.
Cosyntropin is typically administered as an injection, and its effects on cortisol production are measured through blood tests taken at various time points after administration. This test, known as a cosyntropin stimulation test or ACTH stimulation test, can help diagnose conditions that affect the adrenal glands, such as Addison's disease or adrenal insufficiency.
It is important to note that while cosyntropin is a synthetic form of ACTH, it is not identical to the natural hormone and may have slightly different effects on the body. Therefore, it should only be used under the supervision of a healthcare professional.
Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of certain hormones, primarily cortisol and aldosterone. Cortisol helps regulate metabolism, respond to stress, and suppress inflammation, while aldosterone helps regulate sodium and potassium levels in the body to maintain blood pressure.
Primary adrenal insufficiency, also known as Addison's disease, occurs when there is damage to the adrenal glands themselves, often due to autoimmune disorders, infections, or certain medications. Secondary adrenal insufficiency occurs when the pituitary gland fails to produce enough adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol.
Symptoms of adrenal insufficiency may include fatigue, weakness, weight loss, decreased appetite, nausea, vomiting, diarrhea, abdominal pain, low blood pressure, dizziness, and darkening of the skin. Treatment typically involves replacing the missing hormones with medications taken orally or by injection.
Post-dural puncture headache (PDPH) is a type of headache that can occur following a procedure where the dura mater, the outer layer of the meninges that surrounds the brain and spinal cord, is punctured. This most commonly occurs during lumbar punctures (spinal taps), epidural anesthesia or central line placements.
The headache is typically described as a positional headache, meaning it worsens with sitting upright or standing and improves with lying down. The exact cause of PDPH is not fully understood, but it's thought to be due to the loss of cerebrospinal fluid (CSF) that cushions the brain and spinal cord. This leads to traction on pain-sensitive structures in the head and neck.
PDPH usually begins within 48 hours of the procedure, but can sometimes occur up to five days later. In addition to positional headache, symptoms may include nausea, vomiting, neck stiffness, photophobia (light sensitivity), tinnitus (ringing in the ears), and hearing loss. The headache usually resolves on its own within a few days or weeks, but in some cases, it can last for months or even become chronic. Treatment options include hydration, caffeine, analgesics, and in some refractory cases, an epidural blood patch.
Adrenal cortex function tests are a group of diagnostic tests that evaluate the proper functioning of the adrenal cortex, which is the outer layer of the adrenal glands. These glands are located on top of each kidney and are responsible for producing several essential hormones. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens.
There are several types of adrenal cortex function tests, including:
1. Cortisol testing: This test measures the levels of cortisol in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Cortisol helps regulate metabolism, immune response, and stress response.
2. ACTH (adrenocorticotropic hormone) stimulation test: This test measures the adrenal gland's response to ACTH, a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol. The test involves administering synthetic ACTH and measuring cortisol levels before and after administration.
3. Aldosterone testing: This test measures the levels of aldosterone in the blood or urine to determine if the adrenal glands are producing adequate amounts of this hormone. Aldosterone helps regulate electrolyte balance and blood pressure.
4. Dexamethasone suppression test: This test involves administering dexamethasone, a synthetic corticosteroid, to suppress cortisol production. The test measures cortisol levels before and after administration to determine if the adrenal glands are overproducing cortisol.
5. Androgen testing: This test measures the levels of androgens, such as testosterone and dehydroepiandrosterone (DHEA), in the blood or urine to determine if the adrenal glands are producing excessive amounts of these hormones.
Abnormal results from adrenal cortex function tests may indicate conditions such as Addison's disease, Cushing's syndrome, congenital adrenal hyperplasia, and pheochromocytoma.
Addison disease, also known as primary adrenal insufficiency or hypocortisolism, is a rare endocrine disorder characterized by the dysfunction and underproduction of hormones produced by the adrenal glands, specifically cortisol and aldosterone. The adrenal glands are located on top of the kidneys and play a crucial role in regulating various bodily functions such as metabolism, blood pressure, stress response, and immune system function.
The primary cause of Addison disease is the destruction of more than 90% of the adrenal cortex, which is the outer layer of the adrenal glands responsible for hormone production. This damage can be due to an autoimmune disorder where the body's immune system mistakenly attacks and destroys the adrenal gland tissue, infections such as tuberculosis or HIV, cancer, genetic disorders, or certain medications.
The symptoms of Addison disease often develop gradually and may include fatigue, weakness, weight loss, decreased appetite, low blood pressure, darkening of the skin, and mood changes. In some cases, an acute crisis known as acute adrenal insufficiency or Addisonian crisis can occur, which is a medical emergency characterized by sudden and severe symptoms such as extreme weakness, confusion, dehydration, vomiting, diarrhea, low blood sugar, and coma.
Diagnosis of Addison disease typically involves blood tests to measure hormone levels, imaging studies such as CT scans or MRIs to assess the adrenal glands' size and structure, and stimulation tests to evaluate the adrenal glands' function. Treatment usually involves replacing the missing hormones with medications such as hydrocortisone, fludrocortisone, and sometimes mineralocorticoids. With proper treatment and management, individuals with Addison disease can lead normal and productive lives.
Hydrocortisone is a synthetic glucocorticoid, which is a class of steroid hormones. It is identical to the naturally occurring cortisol, a hormone produced by the adrenal gland that helps regulate metabolism and helps your body respond to stress. Hydrocortisone has anti-inflammatory effects and is used to treat various inflammatory conditions such as allergies, skin disorders, and autoimmune diseases. It works by suppressing the immune system's response to reduce swelling, redness, itching, and other symptoms caused by inflammation.
Hydrocortisone is available in different forms, including oral tablets, topical creams, lotions, gels, and ointments, as well as injectable solutions. The specific use and dosage depend on the condition being treated and the individual patient's medical history and current health status.
As with any medication, hydrocortisone can have side effects, especially when used in high doses or for extended periods. Common side effects include increased appetite, weight gain, mood changes, insomnia, and skin thinning. Long-term use of hydrocortisone may also increase the risk of developing osteoporosis, diabetes, cataracts, and other health problems. Therefore, it is essential to follow your healthcare provider's instructions carefully when using this medication.
A spinal puncture, also known as a lumbar puncture or a spinal tap, is a medical procedure in which a thin, hollow needle is inserted between two vertebrae in the lower back to extract cerebrospinal fluid (CSF) from the subarachnoid space. This procedure is typically performed to diagnose conditions affecting the central nervous system, such as meningitis, encephalitis, or subarachnoid hemorrhage, by analyzing the CSF for cells, chemicals, bacteria, or viruses. Additionally, spinal punctures can be used to administer medications or anesthetics directly into the CSF space, such as in the case of epidural anesthesia during childbirth.
The medical definition of a spinal puncture is: "A diagnostic and therapeutic procedure that involves introducing a thin needle into the subarachnoid space, typically at the lumbar level, to collect cerebrospinal fluid or administer medications."
The adrenal glands are a pair of endocrine glands that are located on top of the kidneys. Each gland has two parts: the outer cortex and the inner medulla. The adrenal cortex produces hormones such as cortisol, aldosterone, and androgens, which regulate metabolism, blood pressure, and other vital functions. The adrenal medulla produces catecholamines, including epinephrine (adrenaline) and norepinephrine (noradrenaline), which help the body respond to stress by increasing heart rate, blood pressure, and alertness.
Ciprofloxacin is a fluoroquinolone antibiotic that is used to treat various types of bacterial infections, including respiratory, urinary, and skin infections. It works by inhibiting the bacterial DNA gyrase, which is an enzyme necessary for bacterial replication and transcription. This leads to bacterial cell death. Ciprofloxacin is available in oral and injectable forms and is usually prescribed to be taken twice a day. Common side effects include nausea, diarrhea, and headache. It may also cause serious adverse reactions such as tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects. It is important to note that ciprofloxacin should not be used in patients with a history of hypersensitivity to fluoroquinolones and should be used with caution in patients with a history of seizures, brain injury, or other neurological conditions.
Drug Information Services (DIS) are specialized resources within healthcare systems, typically staffed by clinical pharmacists and pharmacy residents, that provide evidence-based information and analysis about medications to healthcare professionals and patients. The primary goal of DIS is to optimize medication use and improve patient outcomes through the provision of accurate, unbiased, and timely information on drug therapy.
DIS commonly provide a range of services, including:
1. Answering medication-related questions from healthcare providers, such as physicians, nurses, and other pharmacists, regarding drug interactions, dosing, adverse effects, and therapeutic alternatives.
2. Developing and maintaining formulary management systems to ensure the safe and cost-effective use of medications within a healthcare institution or system.
3. Providing patient education materials and resources on medication therapy, including proper administration techniques, potential side effects, and storage requirements.
4. Conducting ongoing literature evaluations and synthesizing evidence-based recommendations for medication use in various clinical scenarios.
5. Collaborating with healthcare teams to develop and implement guidelines, policies, and procedures related to medication management and safety.
6. Offering educational programs and resources for healthcare professionals and students to enhance their knowledge of pharmacotherapy and medication safety practices.
7. Participating in multidisciplinary committees focused on improving medication use processes, reducing medication errors, and promoting patient safety.
DIS are essential components of modern healthcare systems, as they help ensure the safe, effective, and efficient use of medications for improved patient outcomes.
Anti-infective agents are a class of medications that are used to treat infections caused by various microorganisms such as bacteria, viruses, fungi, and parasites. These agents work by either killing the microorganism or inhibiting its growth, thereby helping to control the infection and alleviate symptoms.
There are several types of anti-infective agents, including:
1. Antibiotics: These are medications that are used to treat bacterial infections. They work by either killing bacteria (bactericidal) or inhibiting their growth (bacteriostatic).
2. Antivirals: These are medications that are used to treat viral infections. They work by interfering with the replication of the virus, preventing it from spreading and causing further damage.
3. Antifungals: These are medications that are used to treat fungal infections. They work by disrupting the cell membrane of the fungus, killing it or inhibiting its growth.
4. Antiparasitics: These are medications that are used to treat parasitic infections. They work by either killing the parasite or inhibiting its growth and reproduction.
It is important to note that anti-infective agents are not effective against all types of infections, and it is essential to use them appropriately to avoid the development of drug-resistant strains of microorganisms.
I'm sorry for any confusion, but "pamphlets" is not a medical term. It refers to a small paper booklet or leaflet that can be used to provide information on various topics, including non-medical subjects. If you have any questions about medical terminology or concepts, I'd be happy to help with those!
Fluoroquinolones are a class of antibiotics that are widely used to treat various types of bacterial infections. They work by interfering with the bacteria's ability to replicate its DNA, which ultimately leads to the death of the bacterial cells. Fluoroquinolones are known for their broad-spectrum activity against both gram-positive and gram-negative bacteria.
Some common fluoroquinolones include ciprofloxacin, levofloxacin, moxifloxacin, and ofloxacin. These antibiotics are often used to treat respiratory infections, urinary tract infections, skin infections, and gastrointestinal infections, among others.
While fluoroquinolones are generally well-tolerated, they can cause serious side effects in some people, including tendonitis, nerve damage, and changes in mood or behavior. As with all antibiotics, it's important to use fluoroquinolones only when necessary and under the guidance of a healthcare provider.
Microbial sensitivity tests, also known as antibiotic susceptibility tests (ASTs) or bacterial susceptibility tests, are laboratory procedures used to determine the effectiveness of various antimicrobial agents against specific microorganisms isolated from a patient's infection. These tests help healthcare providers identify which antibiotics will be most effective in treating an infection and which ones should be avoided due to resistance. The results of these tests can guide appropriate antibiotic therapy, minimize the potential for antibiotic resistance, improve clinical outcomes, and reduce unnecessary side effects or toxicity from ineffective antimicrobials.
There are several methods for performing microbial sensitivity tests, including:
1. Disk diffusion method (Kirby-Bauer test): A standardized paper disk containing a predetermined amount of an antibiotic is placed on an agar plate that has been inoculated with the isolated microorganism. After incubation, the zone of inhibition around the disk is measured to determine the susceptibility or resistance of the organism to that particular antibiotic.
2. Broth dilution method: A series of tubes or wells containing decreasing concentrations of an antimicrobial agent are inoculated with a standardized microbial suspension. After incubation, the minimum inhibitory concentration (MIC) is determined by observing the lowest concentration of the antibiotic that prevents visible growth of the organism.
3. Automated systems: These use sophisticated technology to perform both disk diffusion and broth dilution methods automatically, providing rapid and accurate results for a wide range of microorganisms and antimicrobial agents.
The interpretation of microbial sensitivity test results should be done cautiously, considering factors such as the site of infection, pharmacokinetics and pharmacodynamics of the antibiotic, potential toxicity, and local resistance patterns. Regular monitoring of susceptibility patterns and ongoing antimicrobial stewardship programs are essential to ensure optimal use of these tests and to minimize the development of antibiotic resistance.
Drug labeling refers to the information that is provided on the packaging or container of a medication, as well as any accompanying promotional materials. This information is intended to provide healthcare professionals and patients with accurate and up-to-date data about the drug's composition, intended use, dosage, side effects, contraindications, and other important details that are necessary for safe and effective use.
The labeling of prescription drugs in the United States is regulated by the Food and Drug Administration (FDA), which requires manufacturers to submit proposed labeling as part of their new drug application. The FDA reviews the labeling to ensure that it is truthful, balanced, and not misleading, and provides accurate information about the drug's risks and benefits.
The labeling of over-the-counter (OTC) drugs is also regulated by the FDA, but in this case, the agency has established a set of monographs that specify the conditions under which certain active ingredients can be used and the labeling requirements for each ingredient. Manufacturers of OTC drugs must ensure that their labeling complies with these monographs.
In addition to the information required by regulatory agencies, drug labeling may also include additional information provided by the manufacturer, such as detailed instructions for use, storage requirements, and any warnings or precautions that are necessary to ensure safe and effective use of the medication. It is important for healthcare professionals and patients to carefully review and understand all of the information provided on a drug's labeling before using the medication.
Adrenocorticotropic hormone (medication)
ACTH stimulation test
Addison's disease
Cerebrospinal fluid leak
Post-dural-puncture headache
Desonide
Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
Clascoterone
Adrenal crisis
C136H210N40O31S
List of MeSH codes (D06)
List of MeSH codes (D12.644)
Cortrosyn, Synthetic ACTH (cosyntropin) dosing, indications, interactions, adverse effects, and more
Adrenal Insufficiency, ACTH (Cosyntropin) Test and Steroid Interaction | Karine Wong, Pharm.D. | RxEconsult
Cosyntropin | Qwark Health
Cosyntropin | CHEO ED Outreach
Cosyntropin (Cortrosyn) | Davis's Drug Guide
ACTH (Cosyntropin) Stimulation Test - TheWetLab
Cosyntropin Hormone Peptide Activator Catalog Number KS061034 CAS 16960-16-0
Adrenocorticotropic hormone (medication) - Wikipedia
ACTH stimulation test: MedlinePlus Medical Encyclopedia
Autoimmune polyglandular syndrome, type II
Ciprofloxacin (Otic Route) Description and Brand Names - Mayo Clinic
Ciprofloxacin (Intravenous) Advanced Patient Information - Drugs.com
Dr. Nigel Spier, MD - Obstetrics & Gynecology Specialist in Hollywood, FL | Healthgrades
Dr. Elizabeth Baltaro, MD - Family Medicine Specialist in Durham, NC | Healthgrades
Addison's disease: Diagnosis
Corticotropin Stimulation Test
Dr. David Spees, MD, Family Medicine Specialist - San Diego, CA | Sharecare
Dr. Shweta Sharan, MD, Family Medicine Specialist - Monroe, LA | Sharecare
Congenital Adrenal Hyperplasia Caused by 21-Hydroxylase Deficiency - Pediatrics - Merck Manuals Professional Edition
Effects of adrenal function tests on the levels of endogenous digitalis-like substances and some pituitary hormones | Lund...
Adrenal Hemorrhage: Practice Essentials, Pathophysiology, Epidemiology
Role of Hydrocortisone, Fludrocortisone in Septic Shock
Virormone Injection - Side Effects, Uses, Dosage, Overdose, Pregnancy, Alcohol | RxWiki
Congenital Adrenal Hyperplasia - CAH | Choose the Right Test
Pathology Outlines - Adrenal insufficiency-diagnosis
Amy E. DeClue<...
procainamide, Pronestyl; Procan-SR; Procanbid Side Effects - Hdkino.org
Endocrine Society Reading Room | Controversies in Assessment and Management of Adrenal Insufficiency in Cirrhosis | MedPage...
RX List database - use generic or medication brand name - GlobalRPH
Cortisol7
- When administered, cosyntropin stimulates the production and release of cortisol from the adrenal glands. (qwarkhealth.com)
- Cosyntropin is primarily used in a medical setting to assess adrenal gland function, particularly in conditions such as adrenal insufficiency (lack of cortisol production). (qwarkhealth.com)
- An ACTH stimulation test measures your adrenal glands' production of cortisol in response to an injected cosyntropin. (wetlab.org)
- When the doctor gives the person cosyntropin, the adrenal glands should release cortisol into the blood. (medicalnewstoday.com)
- Total and free cortisol levels during 1 μg, 25 μg, and 250 μg cosyntropin stimulation tests compared to insulin tolerance test: results of a randomized, prospective, pilot study. (hopkinsmedicine.org)
- The standard protocol is measurement of circulating cortisol concentration before and one hour after a single intramuscular or intravenous injection of synthetic ACTH (tetracosactrin, cosyntropin) at 250 μg/dog, although doses as low as 1.0 µg/kg can be used. (vin.com)
- This test consists of measuring serum cortisol immediately before and approximately 60 minutes after intravenous injection of 250 mcg (one vial) of cosyntropin. (medscape.com)
Cortrosyn2
- The short cosyntropin (Cortrosyn) stimulation test confirms the diagnosis of adrenal insufficiency. (medscape.com)
- Cosyntropin (cortrosyn) is a wax it has to consider adolescents specifically. (stonecottagegardens.com)
ACTH Stim2
- The doctor resumes all her medications and orders a cosyntropin or adrenocorticotropic hormone (ACTH) stimulation test. (rxeconsult.com)
- For low dose ACTH Stimulation test , dilute 1 mL (1 mcg) cosyntropin syringe received from pharmacy with 2 mL normal saline for a total volume of 3 mL. (cheo.on.ca)
Corticotropin2
- Cosyntropin, also known as corticotropin, is a synthetic form of a hormone called adrenocorticotropic hormone (ACTH) that is naturally produced by the pituitary gland. (qwarkhealth.com)
- Adrenal Cortical Steroids - Cosyntropin and corticotropin are used as a diagnostic tool for dogs with Addison's disease and Cushing's disease. (petcarerx.com)
Synacthen1
- 84 The form that is made synthetically is tetracosactide, also known as synacthen, tetracosactrin and cosyntropin. (wikipedia.org)
Tetracosactide1
- Cosyntropin, also known as tetracosactide, is a synthetic hormone medication that is primarily used for diagnostic testing of the adrenal gland function. (qwarkhealth.com)
Recommended for diagnosing adrenal in1
- The cosyntropin test is recommended for diagnosing adrenal insufficiency, which must be present to diagnose this syndrome. (nih.gov)
0.25 mg1
- Cosyntropin is administered as 0.25 mg IV slow push over 2 minutes. (rxeconsult.com)
Test12
- The problem is that there is a drug-test interaction with cosyntropin and prednisone. (rxeconsult.com)
- Cosyntropin is adrenocorticotropic hormone (ACTH), used to test for adrenal insufficiency. (rxeconsult.com)
- How is an ACTH (cosyntropin) stimulation test performed? (wetlab.org)
- How long does an ACTH (cosyntropin) stimulation test take? (wetlab.org)
- What is the cost of an ACTH (cosyntropin) stimulation test? (wetlab.org)
- What are the benefits of an ACTH (cosyntropin) stimulation test? (wetlab.org)
- Who should have an ACTH (cosyntropin) stimulation test? (wetlab.org)
- There will be one test before the doctor gives cosyntropin and other tests after 30 minutes and 60 minutes. (medicalnewstoday.com)
- Everyone in that study had a cosyntropin stim test and only certain subgroups had better outcomes. (medscape.com)
- Because one part of the Annane protocol was already deemed unnecessary (the cosyntropin stim test), it was easy to dismiss fludrocortisone after COIITTS was published. (medscape.com)
- hence, TC remains the preferred modality for HPA axis assessment, with guidelines recommending use of standard dose cosyntropin test. (medpagetoday.com)
- The test is often done before and 1 hour after injection of a medicine called ACTH (cosyntropin). (ucsfhealth.org)
Synthetic form1
- Next, they will inject you with a synthetic form of ACTH called cosyntropin. (wetlab.org)
Baseline1
- Serum ACTH should also be drawn at baseline before administration of cosyntropin in order to distinguish primary from secondary adrenal insufficiency. (medscape.com)
Medication1
- As with any medication, there may be potential side effects associated with the use of cosyntropin. (qwarkhealth.com)
Treatment3
- It is worth noting that cosyntropin is not a standalone treatment for any specific medical condition. (qwarkhealth.com)
- Additionally, Cosyntropin may cause an increase in blood pressure, so regular monitoring of blood pressure levels is necessary during treatment. (qwarkhealth.com)
- If you are pregnant or breastfeeding, it is important to discuss the potential risks and benefits of using Cosyntropin with your healthcare provider before starting or continuing treatment. (qwarkhealth.com)
Note1
- It's important to note that cosyntropin should only be administered under medical supervision and as prescribed by a healthcare professional. (qwarkhealth.com)
Important2
- Before using Cosyntropin, it is important to be aware of certain warnings associated with its use. (qwarkhealth.com)
- Before taking Cosyntropin, it is important to be aware of certain warnings and precautions. (qwarkhealth.com)
ACTH13
- Cosyntropin is α 1-24 corticotropin, a synthetic subunit of ACTH. (nih.gov)
- Cosyntropin injection exhibits the full corticosteroidogenic activity of natural ACTH. (nih.gov)
- The pharmacologic profile of cosyntropin injection is similar to that of purified natural ACTH. (nih.gov)
- It has been established that 0.25 mg of cosyntropin injection will stimulate the adrenal cortex maximally and to the same extent as 25 units of natural ACTH. (nih.gov)
- The extra-adrenal effects which natural ACTH and cosyntropin injection have in common include increased melanotropic activity, increased growth hormone secretion and an adipokinetic effect. (nih.gov)
- This property of cosyntropin injection assumes added importance in view of the known antigenicity of natural ACTH. (nih.gov)
- Cosyntropin injection exhibits slight immunologic activity, does not contain animal protein and is therefore less risky to use than natural ACTH. (nih.gov)
- Patients are given an injection of a drug called "ACTH" or "cosyntropin," which is a version of a hormone normally produced by the pituitary gland. (nih.gov)
- The normal cortisol response 30 or 60 minutes after cosyntropin (ACTH [1-24] ) is considered to be ≥18 μg/dL (500 nmol/L). This threshold is based on older serum cortisol assays. (medscape.com)
- La ACTH (1-24), un segmento similar en todas las especies, posee la actividad biológica, que estimula la producción CORTICOESTEROIDES en la CORTEZA SUPRARRENAL. (bvsalud.org)
- An ACTH (cosyntropin) stim test is used to test the functioning of your adrenal glands (which sit on top of your kidneys). (nursedonnareese.com)
- Cosyntropin is a man-made form of the adrenocorticotropic (ACTH) hormone that normally stimulates the adrenal glands to produce cortisol. (cushingsdiseasenews.com)
- This cortisol test is used for cortrosyn (COSYNTROPIN or ACTH) Stimulation screening for adrenocortical insufficiency. (pathregional.com)
Stimulation test2
- normal range if done as part of a cosyntropin stimulation test or dexamethasone suppression test. (nih.gov)
- This can be investigated by tapering to a physiologic steroid dose and then performing a cosyntropin stimulation test. (unboundmedicine.com)
Peak cortisol1
- Peak cortisol response was evaluated by a standard 250 µg cosyntropin test. (uib.no)
Injection7
- Cosyntropin Injection is a 1 mL sterile solution in vials containing 0.25 mg of cosyntropin, 0.82 mg sodium acetate trihydrate, 6.4 mg sodium chloride, 10 mg mannitol, 1 mg glacial acetic acid, and water for injection, USP. (nih.gov)
- This dose of cosyntropin injection will produce maximal secretion of 17-OH corticosteroids, 17-ketosteroids and/or 17-ketogenic steroids. (nih.gov)
- Cosyntropin injection is intended for use as a diagnostic agent in the screening of patients presumed to have adrenocortical insufficiency. (nih.gov)
- When presumptive adrenal insufficiency is diagnosed by a subnormal cosyntropin injection test, further studies are indicated to determine if it is primary or secondary. (nih.gov)
- Patients selected for further study as the result of a subnormal cosyntropin injection test should be given a 3 or 4 day course of treatment with Repository Corticotropin Injection USP and then retested. (nih.gov)
- The only contraindication to cosyntropin injection is a history of a previous adverse reaction to it. (nih.gov)
- Cosyntropin for injection is a sterile lyophilized powder in vials containing 0.25 mg of cosyntropin and 10 mg of mannitol to be reconstituted with 1 mL of 0.9% Sodium Chloride Injection, USP. (nih.gov)
Intravenous1
- NATIONAL HARBOR, MD - Intravenous (IV) cosyntropin therapy in the treatment of postdural puncture headache shows efficacy that is similar to that of, but is slower to take effect than, the current gold standard treatment, an epidural blood patch, a new study shows. (medscape.com)
Adrenal insufficiency1
- BACKGROUND: Cosyntropin stimulation testing (CST) is used to screen patients for adrenal insufficiency (AI). (wustl.edu)
Synthetic2
- Anecdotal reports have suggested adrenocorticotropic hormone derivatives have some benefit in the treatment of postdural puncture headache, with the synthetic derivative cosyntropin in particular showing efficacy compared with placebo for treatment of the headaches, as well as representing a possible prophylactic agent. (medscape.com)
- 3. She then injected cosyntropin, a synthetic version of cortisol. (nursedonnareese.com)
Suppression2
- In 15 of 53 (28%) evaluable patients, adrenal suppression was indicated by either a pre-stimulated cortisol concentration less than or equal to 5 mcg/dL pre-stimulation cortisol, or a cosyntropin post-stimulation cortisol less than or equal to 18 mcg/dL and an increase of less than 7 mcg/dL from the baseline cortisol. (nih.gov)
- Hypothalamic pituitary adrenal axis suppression was evaluated with intramuscular cosyntropin stimulation and metyrapone administration during treatment. (johnshopkins.edu)
Stimulate1
- The cosyntropin is used to hopefully stimulate the adrenals to make cortisol. (nursedonnareese.com)
Blood glucose1
- Because cosyntropin is linked to hypertension and increased blood glucose, patients who would likely not be good candidates include patients with diabetes, those at risk for infection, and those with blood pressure concerns, Dr Hanling added. (medscape.com)
Patients3
- To determine how well cosyntropin holds up in a noninferiority study with the epidural blood patch, Dr Hanling and his colleagues randomly assigned 28 patients from 2007 to 2013 to receive the epidural blood patch (n = 13) or IV cosyntropin for postdural puncture headache (n = 15). (medscape.com)
- There were, however, substantial differences in the percentage of patients returning to the emergency department after treatment for continued headache symptoms: 8.4% of patients in the epidural blood patch vs 60% of patients in the cosyntropin group. (medscape.com)
- Situations when cosyntropin may be particularly beneficial as an alternative to an epidural blood patch include patients who have contraindications to blood patches (eg, those with coagulopathy), certain malignancies, and efforts to spare pediatric pain patients additional epidural injections. (medscape.com)
Include1
- Mechanisms of cosyntropin believed to relieve postdural puncture headache include a stimulated endorphin release, anti-inflammatory action, fluid and electrolyte retention, and the direct stimulation of cerebral spinal fluid (CSF) production, Dr Hanling explained. (medscape.com)
Produce1
- The man's ability to produce cortisol following stimulation with cosyntropin was assessed. (cushingsdiseasenews.com)
Therapy1
- Comparison of Cosyntropin, Vigabatrin, and Combination Therapy in New-Onset Infantile Spasms in a Prospective Randomized Trial. (sc-ctsi.org)
Alternative1
- The findings suggest cosyntropin may offer a lower-cost, noninvasive alternative that could be beneficial in various important settings, researchers say. (medscape.com)
