関: cosyntropin、tetracosactide

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/04/30 23:48:35」(JST)

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Cosyntropin (Cortrosyn) is a synthetic derivative of adrenocorticotropic hormone (ACTH) that is used in the ACTH stimulation test to evaluate and diagnose cortisol disorders. Cosyntropin contains only the first 24 (of a total 39) amino acids of ACTH but retains full function.^[1]

In patients with low cortisol levels or symptoms of adrenocortical insufficiency, cosyntropin can be used to diagnose Addison's disease. A failure for serum cortisol levels to increase after administration of cosyntropin makes a diagnosis of primary adrenocortical insufficiency more likely. An increase in cortisol upon administration of cosyntropin rules out the condition. The test may also be used to assess the function of the adrenal glands after successful treatment for Cushing's syndrome.

Cosyntropin is also used in the opposite situation, when there is aldosterone hypersecretion due to either a unilateral adrenal adenoma (which is treated by surgical removal) or bilateral adrenal hyperplasia (treated by oral spironolactone). A procedure called adrenal venous sampling may be used pre-operatively to localize the source of aldosterone hypersecretion from either adrenal gland. A peripheral intravenous infusion of Cosyntropin before and during the procedure stimulates cortisol production and thereby verifies catheter position.^[2]

References

^ Cortrosyn information
^ J Vasc Interv Radiol 2004 Nov;15(11):1245-50. Comparison of sequential versus simultaneous methods of adrenal venous sampling. Carr CE, Cope C, Cohen DL, Fraker DL, Trerotola SO. http://www.ncbi.nlm.nih.gov/pubmed?term=15525743

External links

Cosyntropin at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

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1. 副腎不全におけるACTHに対する反応の評価 evaluation of the response to acth in adrenal insufficiency
2. 成人における副腎不全の診断 diagnosis of adrenal insufficiency in adults
3. コルチコトロピン-放出ホルモン（CRH）刺激試験 corticotropin releasing hormone stimulation test
4. 敗血症性ショックのステロイド療法 corticosteroid therapy in septic shock
5. ステロイドの中断 glucocorticoid withdrawal

English Journal

Drug therapy for treating post-dural puncture headache.

Basurto Ona X1, Osorio D, Bonfill Cosp X.
The Cochrane database of systematic reviews.Cochrane Database Syst Rev.2015 Jul 15;7:CD007887. [Epub ahead of print]
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 8, 2011, on 'Drug therapy for treating post-dural puncture headache'.Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture, an invasive procedure frequently performed in the eme
PMID 26176166

Intra-adrenal Aldosterone Secretion: Segmental Adrenal Venous Sampling for Localization.

Satani N1, Ota H1, Seiji K1, Morimoto R1, Kudo M1, Iwakura Y1, Ono Y1, Nezu M1, Omata K1, Ito S1, Satoh F1, Takase K1.
Radiology.Radiology.2015 Jul 6:142159. [Epub ahead of print]
Purpose To use segmental adrenal venous sampling (AVS) (S-AVS) of effluent tributaries (a version of AVS that, in addition to helping identify aldosterone hypersecretion, also enables the evaluation of intra-adrenal hormone distribution) to detect and localize intra-adrenal aldosterone secretion. Ma
PMID 26147784

Defining contralateral adrenal suppression in primary aldosteronism: implications for diagnosis and outcome.

Kline GA1, Chin A2, So B3, Harvey A4, Pasieka JL4.
Clinical endocrinology.Clin Endocrinol (Oxf).2015 Jul;83(1):20-7. doi: 10.1111/cen.12669. Epub 2015 Jan 6.
OBJECTIVE: Unilateral primary aldosteronism (PA) should have a contralaterally normal and therefore suppressed adrenal zona glomerulosa. However, there is no validated definition of adrenal suppression. We created two biochemical hypotheses of adrenal suppression based upon measurements taken during
PMID 25400021

Japanese Journal

健康成人を対象とした第1相試験におけるRapid ACTH Testの評価基準の検討

臨床薬理 31(4), 557-563, 2000-07-31
NAID 10010947027

発達障害が軽いＡｉｃａｒｄｉ症候群の５歳女児例

脳と発達 22(4), 376-380, 1990
NAID 130004068080

Effect of Prolonged ACTH Stimulation on Adrenal Renin and Aldosterone.

Endocrinologia Japonica 35(5), 763-768, 1988
NAID 130000952975

Related Pictures

Cortrosyn, Synthetic ACTH (cosyntropin) dosing, indications Cosyntropin; ACTH (1-24); Tetracosactide; Tetracosactrin Cortrosyn - patient information, description, dosage and directions. Cortrosyn injection : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing Cortrosyn | AMPHASTAR cosyntropin injection : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing Insights into Veterinary Endocrinology: How Does the New Generic Cosyntropin Compare

★リンクテーブル★

リンク元	「テトラコサクチド」「cosyntropin」

「テトラコサクチド」

Cosyntropin
	IUPAC name L-seryl-L-tyrosyl-L-seryl-L-methionyl-L-α-glutamyl-L-histidyl-L-phenylalanyl-L-arginyl-L-tryptophylglycyl-L-lysyl-L-prolyl-L-valylglycyl-L-lysyl-L-lysyl-L-arginyl-L-arginyl-L-prolyl-L-valyl-L-lysyl-L-valyl-L-tyrosyl-L-proline
	Other names Ser-Tyr-Ser-Met-Glu-His-Phe-Arg-Trp-Gly-Lys-Pro-Val-Gly-Lys-Lys-Arg-Arg-Pro-Val-Lys-Val-Tyr-Pro
Identifiers
CAS number	16960-16-0
PubChem	16133751
ChemSpider	10481947
UNII	72YY86EA29
DrugBank	DB01284
ChEMBL	CHEMBL1201443
	InChI InChI=1S/C136H210N40O31S/c1-75(2)109(127(200)154-71-106(181)156-88(31-13-17-52-137)114(187)158-89(32-14-18-53-138)115(188)159-91(35-21-56-149-134(142)143)116(189)164-96(37-23-58-151-136(146)147)131(204)175-60-25-39-104(175)126(199)173-111(77(5)6)128(201)163-90(33-15-19-54-139)120(193)171-110(76(3)4)129(202)169-101(65-80-43-47-84(180)48-44-80)132(205)176-61-26-40-105(176)133(206)207)172-125(198)103-38-24-59-174(103)130(203)95(34-16-20-55-140)157-107(182)70-153-113(186)99(66-81-68-152-87-30-12-11-29-85(81)87)167-117(190)92(36-22-57-150-135(144)145)160-121(194)98(63-78-27-9-8-10-28-78)166-123(196)100(67-82-69-148-74-155-82)168-118(191)93(49-50-108(183)184)161-119(192)94(51-62-208-7)162-124(197)102(73-178)170-122(195)97(165-112(185)86(141)72-177)64-79-41-45-83(179)46-42-79/h8-12,27-30,41-48,68-69,74-77,86,88-105,109-111,152,177-180H,13-26,31-40,49-67,70-73,137-141H2,1-7H3,(H,148,155)(H,153,186)(H,154,200)(H,156,181)(H,157,182)(H,158,187)(H,159,188)(H,160,194)(H,161,192)(H,162,197)(H,163,201)(H,164,189)(H,165,185)(H,166,196)(H,167,190)(H,168,191)(H,169,202)(H,170,195)(H,171,193)(H,172,198)(H,173,199)(H,183,184)(H,206,207)(H4,142,143,149)(H4,144,145,150)(H4,146,147,151)/t86-,88-,89-,90-,91-,92-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,103-,104-,105-,109-,110-,111-/m0/s1; Key: ZOEFCCMDUURGSE-SQKVDDBVSA-N InChI=1/C136H210N40O31S/c1-75(2)109(127(200)154-71-106(181)156-88(31-13-17-52-137)114(187)158-89(32-14-18-53-138)115(188)159-91(35-21-56-149-134(142)143)116(189)164-96(37-23-58-151-136(146)147)131(204)175-60-25-39-104(175)126(199)173-111(77(5)6)128(201)163-90(33-15-19-54-139)120(193)171-110(76(3)4)129(202)169-101(65-80-43-47-84(180)48-44-80)132(205)176-61-26-40-105(176)133(206)207)172-125(198)103-38-24-59-174(103)130(203)95(34-16-20-55-140)157-107(182)70-153-113(186)99(66-81-68-152-87-30-12-11-29-85(81)87)167-117(190)92(36-22-57-150-135(144)145)160-121(194)98(63-78-27-9-8-10-28-78)166-123(196)100(67-82-69-148-74-155-82)168-118(191)93(49-50-108(183)184)161-119(192)94(51-62-208-7)162-124(197)102(73-178)170-122(195)97(165-112(185)86(141)72-177)64-79-41-45-83(179)46-42-79/h8-12,27-30,41-48,68-69,74-77,86,88-105,109-111,152,177-180H,13-26,31-40,49-67,70-73,137-141H2,1-7H3,(H,148,155)(H,153,186)(H,154,200)(H,156,181)(H,157,182)(H,158,187)(H,159,188)(H,160,194)(H,161,192)(H,162,197)(H,163,201)(H,164,189)(H,165,185)(H,166,196)(H,167,190)(H,168,191)(H,169,202)(H,170,195)(H,171,193)(H,172,198)(H,173,199)(H,183,184)(H,206,207)(H4,142,143,149)(H4,144,145,150)(H4,146,147,151)/t86-,88-,89-,90-,91-,92-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,103-,104-,105-,109-,110-,111-/m0/s1; Key: ZOEFCCMDUURGSE-SQKVDDBVBT ;
Properties
Molecular formula	C136H210N40O31S
Molar mass	2933.437 g/mol
	Except where noted otherwise, data are given for materials in their standard state (at 25 °C (77 °F), 100 kPa)
	Infobox references