A-Z Drug Facts > Cosyntropin (Synthetic Corticotropin;Synthetic ACTH)

Cosyntropin

( Synthetic Corticotropin; Synthetic ACTH ) Pronouncation: (koe-sin-TROE-pin)
Class: Adrenalcortical steroid

Trade Names:
Cortrosyn
- Powder for Injection 0.25 mg

Pharmacology

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Exhibits full corticosteroidogenic activity of natural ACTH, stimulating adrenal cortex to produce and secrete adrenocortical hormones.

Indications and Usage

Diagnostic testing of adrenal function.

Contraindications

Standard considerations.

Dosage and Administration

Adults

IM/IV (direct injection) 0.25 to 0.75 mg. IV infusion 0.25 mg in D5W or saline 0.9% administered at 0.04 mg/h over 6ߙh.

Children 2 yr of age and younger

IM/IV 0.125 mg often will be sufficient.

General Advice

• Reconstitute 0.25 mg vial with 1 mL of sodium chloride 0.9% for Injection.
• Administer reconstituted drug via IM route or by direct IV injection over 2 min or further dilute in D5W or normal saline for IV infusion.
• Do not allow cosyntropin to mix with blood or plasma infusions.
• Reconstituted preparations should not be retained.

Drug Interactions

Anticholinesterases

May antagonize anticholinesterase effects in myasthenia gravis.

Barbiturates

May decrease pharmacologic effect of cosyntropin.

Hydantoins

May increase clearance and decrease therapeutic efficacy of cosyntropin.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Miscellaneous

Rare hypersensitivity.

Precautions

Monitor Plasma cortisol concentrations Measure plasma cortisol concentrations prior to and 30 to 60 min after administration. Collect blood sample of 6 to 7 mL in heparinized tube. Urinary steroids Alternatively, measure urinary steroids before and after IV infusion.

Pregnancy

Category C .

Lactation

Undetermined.

Hypersensitivity

Exhibits slight immunologic activity but is less likely to cause reactions than natural ACTH.

Patient Information

• Explain purpose of the test.
• Emphasize importance of lab tests.
• Instruct patients taking corticosteroids or aldosterone to omit doses on day of test.

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Adrenocortical Insufficiency

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