코신트로핀

호르몬 진단제

**코신트로핀(Cosyntropin)**은 내인성 부신피질 자극 호르몬(ACTH)의 효과를 모방하는 합성 폴리펩타이드입니다. 수의학에서 주로 진단제로 사용됩니다. * **주요 용도:** 부신 기능 검사(ACTH 자극 검사)를 위한 ACTH 겔의 대체제. * **적응증:** 부신피질 기능 저하증(애디슨병), 의인성 부신피질 기능 항진증(쿠싱 증후군) 진단 및 미토탄 또는 트릴로스탄 치료 반응 모니터링. * **장점:** 내인성 코르티코트로핀의 C-말단 부분이 없기 때문에 면역원성이 현저히 낮아, 과거 동물 유래 ACTH에 알레르기 반응을 보인 환자에게 더 안전합니다.

작용 기전: Cosyntropin acts identically to endogenous ACTH. It binds to **melanocortin type 2 receptors (MC2R)** in the adrenal cortex → stimulates the production of intracellular cAMP → promotes the conversion of cholesterol to pregnenolone → rapidly stimulates the adrenal cortex to secrete **cortisol**, corticosterone, and weak androgens. Because it only contains the first 24 amino acids of natural corticotropin (which has 39), it retains full biological activity but lacks the highly immunogenic C-terminal amino acids (25-39).

동물 종별 용량

Cats

Tentative diagnosis of Addison's disease · 0.125 mg of cosyntropin IV or IM · IV/IM · Once · Draw baseline cortisol, give dexamethasone SP 2-5 mg/kg, give cosyntropin, draw second sample 45-60 mins later.
ACTH Stimulation test · 0.125 mg (total dose-125 mcg) IM or IV · IM/IV · Once · Begin test between 8-9 AM; obtain preinjection cortisol level and 30 minutes and 1 hour post.
Diagnosis of hyperadrenocorticism · 125 micrograms/cat IM or IV · IM/IV · Once · Cortisol measurements before and at 30 and 60 minutes post.
Low dose ACTH stimulation test · 5 micrograms/kg · IV/IM · Once · Cortisol concentrations peak at 60 minutes post-dose.
ACTH stimulation test · 5 μg/kg or 125 μg/cat · IV/IM · once · single dose · Cortisol response is less dramatic than in dogs; use feline-specific reference ranges.

Horses

Relative adrenal insufficiency (RIA) evaluation in critically ill horses · 0.1 micrograms/kg · IV/IM · Once · Cortisol will peak after 30 minutes.
ACTH Stimulation test · 1 mg IV · IV · Once · Administer between 8 and 10 AM; take post ACTH cortisol levels at 2 hours post dose.
ACTH Stimulation test (Foals) · 0.5 micrograms/kg IV · IV · Once · Peak cortisol levels occur at 30 minutes post dose.

Dogs

Tentative diagnosis of Addison's disease · 0.25 mg (250 micrograms) of cosyntropin IV or IM · IV/IM · Once · Draw baseline cortisol, give dexamethasone SP 2-5 mg/kg, give cosyntropin, draw second sample 45-60 mins later.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IMIV

금기

Known hypersensitivity to cosyntropin
No information available

이상반응

Hypersensitivity reactions (rare, but possible)
Pain on intramuscular (IM) injection

약물 상호작용

Hydrocortisone / Cortisone · Cross-reacts with cortisol assays; patients should not receive these on test day (dexamethasone does not interfere).
Spironolactone · May cause falsely high cortisol values if using a fluorometric analysis.

모니터링

Plasma or serum cortisol levels (baseline and post-stimulation)
Patient monitoring for rare hypersensitivity reactions during the test
Serum cortisol levels (baseline/pre-ACTH and post-ACTH, typically at 1 hour post-injection)

과용량

Unlikely to be of clinical consequence if used one-time only for diagnostic purposes.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.