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促腎上腺皮質素 (ACTH)

Corticotropin (ACTH)

Adrenocorticotropic hormone

荷爾蒙診斷劑IM狗貓鳥馬牛

別名: Adrenomone · H.P. Acthar Gel · Adrenocorticotropic hormone · Adrenocorticotrophin · Corticotropinum

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

2.2 Units/kg IMIM· Once
— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
ACTH Stimulation Test2.2 Units/kg IMIMOnce—🌎 NA
ACTH Stimulation Test0.5 Units/kg IMIMOnce—🌎 NA
  • ACTH Stimulation Test: Draw baseline blood sample, administer gel, then draw second sample 120 minutes after injection.
  • ACTH Stimulation Test: Draw baseline blood sample, administer gel, then draw second sample 120 minutes after injection.

貓

適應症劑量途徑頻次療程地區
ACTH Stimulation Test2.2 Units/kg IMIMOnce—🌎 NA
ACTH Stimulation Test0.5 Units/kg IMIMOnce—🌎 NA
  • ACTH Stimulation Test: Draw baseline blood sample, administer gel, then draw samples at 60 minutes and 120 minutes after injection.
  • ACTH Stimulation Test: Draw baseline blood sample, administer gel, then draw sample 120 minutes after injection.

鳥

適應症劑量途徑頻次療程地區
ACTH Stimulation Test16-25 Units IMIMOnce—🌎 NA
  • ACTH Stimulation Test: Draw baseline blood sample for corticosterone (not cortisol), administer IM, draw second sample 1-2 hours later.

馬

適應症劑量途徑頻次療程地區
ACTH Stimulation Test1 Unit/kg IMIMOnce—🌎 NA
ACTH Stimulation Test1 Unit/kg IMIMOnce—🌎 NA
  • ACTH Stimulation Test: Draw baseline blood sample, administer gel, then draw second sample 8 hours later.
  • ACTH Stimulation Test: Administer between 8 and 10 AM; take post ACTH cortisol levels at 2 and 4 hours post dose.

牛

適應症劑量途徑頻次療程地區
ACTH deficiency or primary bovine ketosis200-600 Units initially followed by daily or semi-daily dose of 200-300 UnitsIMdaily or semi-daily—🌎 NA

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

促腎上腺皮質素 (ACTH) 是一種由腦下垂體前葉分泌的 39 個胺基酸多肽荷爾蒙。在獸醫學中，它主要作為​診斷劑​，用於評估腎上腺功能。

  • ​主要用途​：ACTH 刺激試驗用於診斷腎上腺皮質機能低下（愛迪生氏症）、識別醫源性腎上腺皮質機能亢進（庫興氏症候群），以及監測抑制腎上腺治療（如 mitotane 或 trilostane）的效果。
  • ​限制​：與低劑量地塞米松抑制試驗 (LDDST) 相比，作為犬隻自然發生之庫興氏症候群的篩檢工具，其敏感度較低。
  • ​臨床重點​：由於天然豬 ACTH 凝膠產品成本高、取得不易且效力不一，目前現代臨床實務中進行 ACTH 刺激試驗時，多偏好使用合成的 cosyntropin。

作用機制

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).

安全性與警告

禁忌症

  • Hypersensitivity to porcine proteins
  • Intravenous (IV) administration of the repository gel formulation

不良反應

  • Fluid and electrolyte disturbances (with prolonged/chronic use)
  • Hypersensitivity reactions (rare)

注意事項

Do not administer the repository gel form intravenously (IV). Use cautiously during pregnancy (FDA Category C); it may be embryocidal, and benefits must outweigh risks. If used chronically (rare in veterinary medicine), potassium supplementation may be required.

藥物相互作用

Anticholinesterases (e.g., pyridostigmine)

May antagonize effects in patients with myasthenia gravis

Diuretics

May increase electrolyte loss (e.g., hypokalemia) if used chronically

Glucocorticoids (hydrocortisone, cortisone)

Exogenous administration on the day of the test will cross-react with cortisol assays and invalidate test results

監測

  • 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)

藥物動力學

半衰期

狗15 minutes (circulating ACTH)

吸收

Rapidly degraded by proteolytic enzymes in the gut, so it cannot be given PO. After IM injection, the repository gel is absorbed slowly over 8-16 hours.

分佈

Circulates in plasma.

代謝

Rapidly degraded by proteolytic enzymes.

排除

Rapidly cleared from circulation. Despite a short circulating half-life, the slow absorption of the gel formulation allows effects to persist for up to 24 hours.

過量

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.

可用產品

劑型

  • Repository injection (gel)
  • Injection (aqueous)

人用標示

  • Corticotropin Repository Injection: 80 Units/mL in 5 mL multi-dose vials (H.P. Acthar Gel)

各地核准狀態

暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Corticotropin for injection (aqueous) can be stored at room temperature (15-30°C) before reconstitution; after reconstitution, refrigerate and use within 24 hours. Repository corticotropin injection (gel) should be stored in the refrigerator (2-8°C). To allow ease in withdrawing the thick gel into a syringe, the vial may be warmed with warm water prior to use.

飼主須知

您的獸醫師使用此藥物來進行 ​ACTH 刺激試驗​，以評估您寵物的腎上腺功能是否正常。

  • ​測試過程​：測試包含抽取基礎血液樣本、注射此荷爾蒙，並在 1 至 2 小時後（馬匹則需要更長時間）再次抽血。
  • ​安全性​：> ​注意​：這是一項非常安全的診斷測試。單次劑量幾乎不會產生任何副作用。
  • ​事前準備​：請確保您的獸醫師了解您寵物正在服用的所有藥物，特別是任何類固醇藥物（如含氫化可的松的藥膏或藥丸），因為這些藥物會干擾測試結果。

VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。