코신트로핀
Cosyntropin
Tetracosactide
다른 이름: Cortrosyn · Synacthen · Nuvacthen Depot · Cortrosina · tetracosactide · alpha(1-24)corticotrophin · beta(1-24)-corticotrophin · tetracosactido · tetracosactidum · tetracosactrin · tetracosapeptide · Cosyntropin
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Tentative diagnosis of Addison's disease | 0.25 mg (250 micrograms) of cosyntropin IV or IM | IV/IM | Once | — | 🌎 NA |
| ACTH Stimulation test | 1 microgram/kg or 250 micrograms/dog IV or IM | IV/IM | Once | — | 🌎 NA |
| Low dose ACTH stimulation test | 0.5 micrograms/kg IV | IV | Once | — | 🌎 NA |
| ACTH stimulation test | 5 μg/kg | IV/IM | once | single dose | 🌍 EU |
- Tentative diagnosis of Addison's disease: Draw baseline cortisol, give dexamethasone SP 2-5 mg/kg, give cosyntropin, draw second sample 45-60 mins later.
- ACTH Stimulation test: Measure serum cortisol before and 1 hour post injection.
- Low dose ACTH stimulation test: Peak concentrations at 60 minutes after dose.
- ACTH stimulation test: The same doses may be used for the lyophilized product but must be administered IM.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Tentative diagnosis of Addison's disease | 0.125 mg of cosyntropin IV or IM | IV/IM | Once | — | 🌎 NA |
| ACTH Stimulation test | 0.125 mg (total dose-125 mcg) IM or IV | IM/IV | Once | — | 🌎 NA |
| Diagnosis of hyperadrenocorticism | 125 micrograms/cat IM or IV | IM/IV | Once | — | 🌎 NA |
| Low dose ACTH stimulation test | 5 micrograms/kg | IV/IM | Once | — | 🌎 NA |
| ACTH stimulation test | 5 μg/kg or 125 μg/cat | IV/IM | once | single dose | 🌍 EU |
- Tentative diagnosis of Addison's disease: Draw baseline cortisol, give dexamethasone SP 2-5 mg/kg, give cosyntropin, draw second sample 45-60 mins later.
- ACTH Stimulation test: Begin test between 8-9 AM; obtain preinjection cortisol level and 30 minutes and 1 hour post.
- Diagnosis of hyperadrenocorticism: Cortisol measurements before and at 30 and 60 minutes post.
- Low dose ACTH stimulation test: Cortisol concentrations peak at 60 minutes post-dose.
- ACTH stimulation test: Cortisol response is less dramatic than in dogs; use feline-specific reference ranges.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Relative adrenal insufficiency (RIA) evaluation in critically ill horses | 0.1 micrograms/kg | IV/IM | Once | — | 🌎 NA |
| ACTH Stimulation test | 1 mg IV | IV | Once | — | 🌎 NA |
| ACTH Stimulation test (Foals) | 0.5 micrograms/kg IV | IV | Once | — | 🌎 NA |
- Relative adrenal insufficiency (RIA) evaluation in critically ill horses: Cortisol will peak after 30 minutes.
- ACTH Stimulation test: Administer between 8 and 10 AM; take post ACTH cortisol levels at 2 hours post dose.
- ACTH Stimulation test (Foals): Peak cortisol levels occur at 30 minutes post dose.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
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).
안전성·주의사항
금기사항
- Known hypersensitivity to cosyntropin
- No information available
부작용
- Hypersensitivity reactions (rare, but possible)
- Pain on intramuscular (IM) injection
주의
Hypersensitivity Warning: Use with caution in patients who have shown hypersensitive reactions to ACTH in the past, as cross-reactivity is a distinct possibility.
- Laboratory Interference: High bilirubin or free plasma hemoglobin can cause falsely high cortisol values in some assays.
약물 상호작용
Cross-reacts with cortisol assays; patients should not receive these on test day (dexamethasone does not interfere).
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)
약동학
반감기
흡수
Rapidly absorbed after being given IM. Plasma cortisol levels reach their peak within an hour after IM or rapid IV administration.
분포
Rapidly distributed to the adrenal glands.
대사
Inactivated by gut enzymes if given orally. It is unknown exactly how cosyntropin is inactivated or eliminated systemically.
배설
Unknown.
과다투여
Unlikely to be of clinical consequence if used one-time only for diagnostic purposes.
제품
제형
- Solution for Injection
- 0.25 mg/ml injectable solution
- 0.1 mg/ml injectable solution
- 0.25 mg/ml lyophilized powder for injection
인용의약품
- Cosyntropin Powder for Injection: 0.25 mg lyophilized (250 mcg) in single-dose vials with diluent; Cortrosyn (Amphastar)
- Cosyntropin Solution for Injection: 0.25 mg/mL, preservative free in 1 mL single-dose vials; generic (Sandoz)
- Synacthen 0.25 mg/ml solution for injection
규제 현황
Human product often used under the cascade.
POM, Special. Human product used under the cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
After reconstituting with sterile normal saline, the solution is stable for 24 hours at room temperature; 21 days if refrigerated. Do not add the drug to blood or plasma infusions. Reconstituted cosyntropin can be stored frozen (-20°C) in plastic syringes for up to 6 months and retain biologic activity in dogs. It is recommended to freeze in small aliquots to avoid repeated thawing and refreezing.
보호자 정보
진단용으로만 사용: 이 약물은 반려동물의 부신 기능이 얼마나 잘 작동하는지 검사하기 위해 동물병원에서만 사용됩니다.
- 절차: 반려동물의 혈액을 소량 채취한 후 이 약물을 주사하고, 30~60분 후에 다시 혈액을 채취합니다.
- 준비 사항: 스테로이드(히드로코르티손 또는 프레드니손 등)나 스피로놀락톤과 같은 약물은 검사 결과에 영향을 줄 수 있으므로, 반려동물이 복용 중인 모든 약물을 수의사에게 알려주세요.
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