ACTH (COSYNTROPIN) STIMULATION - REGULAR DOSE - (P)
Test Code: ACS
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.
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 above). 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 for cortisol determination.
Requisition for Endocrinology Unit Use Only:
Plasma: 0.5 mL
Pediatric Plasma: 0.2 mL
Serum: 1.0 mL
Normal response is a peak cortisol level > 550 nmol/L