Generic Name

Cosyntropin

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Classification

FDA Approved Indications

• Diagnosis of adrenocortical insufficiency (e.g., Addison's disease)

Mechanism of Action

Cosyntropin stimulates the adrenal cortex to produce cortisol, mimicking endogenous ACTH activity, thus aiding in the assessment of adrenal function.

Dosage and Administration

Adult: For diagnostic testing, 250 mcg IV or IM, usually with cortisol levels measured before and after administration. Dose may vary based on clinical guidelines.

Pediatric: Dose determined based on weight or surface area, typically similar to adult dosing for diagnostic testing.

Geriatric: Use with caution; adjust dosing based on clinical response and renal/hepatic function.

Renal Impairment: Adjustments not typically necessary, but monitor response.

Hepatic Impairment: Use with caution; there are no specific dose adjustments, but hepatic function may influence metabolism.

Pharmacokinetics

Absorption: Rapid absorption when administered IM or IV

Distribution: Distributes well into tissues, cross-reacts with ACTH receptors

Metabolism: Metabolized in the liver and tissues

Excretion: Excreted mainly via kidneys

Half Life: Approximately 30 minutes to 1 hour

Contraindications

• Known hypersensitivity to cosyntropin or other man-made ACTH
• Adrenal tumors

Precautions

• Use cautiously in patients with hypertension, diabetes mellitus, or infection; pregnancy category B

Adverse Reactions - Common

• Injection site pain, swelling (Common)
• Nausea, vomiting (Less common)

Adverse Reactions - Serious

• Severe allergic reactions (rash, itching, swelling, dizziness) (Rare)
• Hypertension or fluid retention (Rare)

Drug-Drug Interactions

• Steroids may alter cortisol response; other medications affecting adrenal function

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report symptoms of allergic reactions immediately.
• Follow instructions for testing procedures.
• Inform about potential side effects such as nausea or swelling.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: N/A

Lab Test Interference: May interfere with cortisol measurements; sample timing is important.

Overdose Management

Signs/Symptoms: Signs of excessive corticotropin activity include hypertension, hypokalemia, hyperglycemia.

Treatment: Discontinue drug; supportive care; manage symptoms accordingly.

Storage and Handling

Storage: Store refrigerated at 2-8°C; protect from light.

Stability: Stable until expiration date on label when properly stored.