ACTH (cosyntropin) stimulation test

Background

• ACTH (cosyntropin) stimulation test measures how well the adrenal glands respond to adrenocorticotropic hormone (ACTH)
• ACTH is a hormone produced in the pituitary gland that stimulates the adrenal glands to release a hormone called cortisol
• Man-made form of ACTH is called cosyntropin

Test

1. Before: Draw serum cortisol
2. Time 0: Give ^0.25mg IM/IV of ACTH (Cosyntropin) over 2min
3. Time 30: Draw serum cortisol
4. Time 60: Draw serum cortisol & give 100mg hydrodortison IVP

^0.125mg if <2yrs old

• Normal Response: Cortisol level doubles from baseline after Cosyntropin administration
• Adrenal Insufficiency: Cortisol level fails to rise after Cosyntropin administration

Management

• Then give either
  • Dexamethasone 6mg IV
  • OR
  • Hydrocortisone 100mg IV

See Also

• Adrenal crisis
• Addison's disease

References

Authors

Ross Donaldson, Tiffany Joe, Daniel Ostermayer, Neil Young, Jordan Swartz