adrenocorticotropic hormone, ACTH

Indications:
Used for active rheumatism, rheumatoid arthritis, lupus erythematosus and other collagen diseases; also used for severe bronchial asthma, severe dermatitis and other allergic diseases and acute leukemia, Hodgkin’s disease, etc.

Usage and dosage:
1. Intramuscular injection, 25 units at a time, twice a day. 2. Intravenous drip, before use, dissolve with 5% glucose injection and apply. 12.5-25 units at a time, 25-50 units a day. 3. Corticotropin stimulation test: dissolve 20-25 units of corticotropin for injection with 500ml of 5% glucose injection, and drip intravenously for 8 hours. Take blood before and after drip to measure plasma cortisol and observe its changes, or collect urine on the day of corticotropin drip to measure urine free cortisol or 17-hydroxycorticosteroids, and compare with the control value of the previous day.

Adverse reactions:
1. Since corticotropin promotes the secretion of cortisol by the adrenal cortex, long-term use can produce glucocorticoid side effects, such as iatrogenic Cushing’s syndrome, obvious water and sodium retention, and considerable potassium loss. 2. The diabetogenic effects, gastrointestinal reactions, and osteoporosis of corticotropin are caused by glucocorticoids, but these side effects are relatively mild when corticotropin is used. 3. Corticotropin stimulates the adrenal cortex to secrete androgens, so the incidence of acne and hirsutism is higher than that of those using glucocorticoids. 4. Long-term use of corticotropin can cause skin pigmentation. Sometimes allergic reactions occur, including fever, rash, angioedema, and occasionally anaphylactic shock. These reactions are more likely to occur in those with anterior pituitary hypofunction, especially primary adrenal hypofunction. When intravenously administering corticotropin to patients suspected of primary adrenal hypofunction for corticotropin testing, it is advisable to take dexamethasone orally, 1 mg per day, to avoid inducing adrenal crisis.

Contraindications:
People who are allergic to this product are prohibited from using it.