์ฝ๋ฅดํฐ์ฝํธ๋กํ (ACTH)
์ฝ๋ฅดํฐ์ฝํธ๋กํ(ACTH)์ ๋ํ์์ฒด ์ ์ฝ์์ ๋ถ๋น๋๋ 39๊ฐ์ ์๋ฏธ๋ ธ์ฐ์ผ๋ก ๊ตฌ์ฑ๋ ํด๋ฆฌํฉํ์ด๋ ํธ๋ฅด๋ชฌ์ ๋๋ค. ์์ํ์์๋ ์ฃผ๋ก ๋ถ์ ๊ธฐ๋ฅ์ ํ๊ฐํ๊ธฐ ์ํ **์ง๋จ์ **๋ก ์ฌ์ฉ๋ฉ๋๋ค. - **์ฃผ์ ์ฉ๋**: ACTH ์๊ทน ์ํ์ ๋ถ์ ํผ์ง ๊ธฐ๋ฅ ์ ํ์ฆ(์ ๋์จ๋ณ)์ ์ง๋จํ๊ณ , ์์ธ์ฑ ๋ถ์ ํผ์ง ๊ธฐ๋ฅ ํญ์ง์ฆ(์ฟ ์ฑ ์ฆํ๊ตฐ)์ ์๋ณํ๋ฉฐ, ๋ถ์ ์ต์ ์น๋ฃ(์: ๋ฏธํ ํ ๋๋ ํธ๋ฆด๋ก์คํ)์ ํจ๊ณผ๋ฅผ ๋ชจ๋ํฐ๋งํ๋ ๋ฐ ์ฌ์ฉ๋ฉ๋๋ค. - **ํ๊ณ์ **: ๊ฐ์์ ์์ฐ์ ์ผ๋ก ๋ฐ์ํ๋ ์ฟ ์ฑ ์ฆํ๊ตฐ์ ์ ๋ณํ๋ ๊ฒ์ฌ๋ก๋ ์ ์ฉ๋ ๋ฑ์ฌ๋ฉํ์ ์ต์ ์ํ(LDDST)์ ๋นํด ๋ฏผ๊ฐ๋๊ฐ ์๋์ ์ผ๋ก ๋ฎ์ต๋๋ค. - **์์ ํ**: ์ฒ์ฐ ๋ผ์ง ACTH ๊ฒ ์ ํ์ ๋์ ๋น์ฉ, ์ ํ๋ ๊ณต๊ธ ๋ฐ ์ญ๊ฐ์ ๋ณ๋์ฑ ๋๋ฌธ์, ํ๋ ์์์์๋ ACTH ์๊ทน ์ํ์ ํฉ์ฑ **์ฝ์ ํธ๋กํ(cosyntropin)**์ ์ฌ์ฉํ๋ ๊ฒ์ด ๋ ์ ํธ๋ฉ๋๋ค.
์์ฉ ๊ธฐ์ : Endogenous ACTH release is controlled by corticotropin-releasing factor (CRF) from the hypothalamus and is subject to negative feedback by glucocorticoids. Exogenous corticotropin binds to **melanocortin-2 receptors (MC2R)** in the **zona fasciculata** of the adrenal cortex $\rightarrow$ stimulates the conversion of cholesterol to pregnenolone via cholesterol desmolase $\rightarrow$ rapidly increases the synthesis and release of **glucocorticoids** (primarily **cortisol** in mammals and **corticosterone** in birds and reptiles).
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- ACTH Stimulation Test ยท 2.2 Units/kg IM ยท IM ยท Once ยท Draw baseline blood sample, administer gel, then draw samples at 60 minutes and 120 minutes after injection.
- ACTH Stimulation Test ยท 0.5 Units/kg IM ยท IM ยท Once ยท Draw baseline blood sample, administer gel, then draw sample 120 minutes after injection.
- ACTH deficiency or primary bovine ketosis ยท 200-600 Units initially followed by daily or semi-daily dose of 200-300 Units ยท IM ยท daily or semi-daily
- ACTH Stimulation Test ยท 1 Unit/kg IM ยท IM ยท Once ยท Draw baseline blood sample, administer gel, then draw second sample 8 hours later.
- ACTH Stimulation Test ยท 1 Unit/kg IM ยท IM ยท Once ยท Administer between 8 and 10 AM; take post ACTH cortisol levels at 2 and 4 hours post dose.
- ACTH Stimulation Test ยท 16-25 Units IM ยท IM ยท Once ยท Draw baseline blood sample for corticosterone (not cortisol), administer IM, draw second sample 1-2 hours later.
- ACTH Stimulation Test ยท 2.2 Units/kg IM ยท IM ยท Once ยท Draw baseline blood sample, administer gel, then draw second sample 120 minutes after injection.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypersensitivity to porcine proteins
- Intravenous (IV) administration of the repository gel formulation
์ด์๋ฐ์
- Fluid and electrolyte disturbances (with prolonged/chronic use)
- Hypersensitivity reactions (rare)
์ฝ๋ฌผ ์ํธ์์ฉ
- Anticholinesterases (e.g., pyridostigmine) ยท May antagonize effects in patients with myasthenia gravis
- Diuretics ยท May increase electrolyte loss (e.g., hypokalemia) if used chronically
- Glucocorticoids (hydrocortisone, cortisone) ยท Exogenous administration on the day of the test will cross-react with cortisol assays and invalidate test results
๋ชจ๋ํฐ๋ง
- Serum cortisol levels (pre- and post-injection for mammals)
- Serum corticosterone levels (pre- and post-injection for birds/reptiles)
- Electrolytes and fluid balance (only if used chronically)
๊ณผ์ฉ๋
When used for diagnostic purposes, acute inadvertent overdoses are highly unlikely to cause any significant adverse effects. Monitor the patient as required and treat symptomatically if necessary.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.