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Laboratory: Clinical Biochemistry  (AUTOMATED)
Test Name:
ACTH (COSYNTROPIN) STIMULATION - REGULAR DOSE - (P)
Test Code: ACS
Clinical Information:
This test is used to assess for primary adrenal insufficiency by measuring cortisol response to ACTH (Cosyntropin) administration.  This test may also be performed in the Endocrinology & Metabolism Clinical Investigation Unit on a consultation basis.  If the patient is taking steroids, plan the test for the morning.  They may take the evening dose, but not the morning dose.
Procedure:
Ward to contact Pharmacy, in advance, to obtain Cosyntropin for administration.  The regular dose is 250 μg.  An endocrinology consult is recommended to establish the appropriate dose.  Use the ACTH Stimulation laboratory requisition (see hyperlink below).  Establish heparin or saline lock.  Draw time 0 sample after a 30 minute rest.  Inject Cosyntropin IM or IV.  Obtain samples at 30 and 60 minutes post dose for cortisol determination.
Samples should be collected at exactly 30 and 60 minutes post cosyntropin administration for apporopriate test interpretation. Samples not collected within 5 minutes of these time points will be processed as random collections.

Requisition for Endocrinology Unit  Use Only:
Collection Devices:
Specimen Required:


Plasma: 0.5 mL
Pediatric Plasma: 0.2 mL

Special Processing: Note: If ACTH (Cosyntropin) Stimulation Test requisition form is not used, or if protocol is not followed, process samples as random cortisol. Samples must be collected within ±5 minutes of specified collection times for appropriate interpretation.
Referral:
Serum: 1.0 mL
Requisition:
Reference Values:
Peak cortisol level:  >350 nmol/L  Normal
Peak cortisol level:  <350 nmol/L  Adrenal Insufficiency
Availability:
Daily
See Also:
More Information: