Corticotropin


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intramuscular, Subcutaneous
Acute exacerbations in multiple sclerosis
Adult: 80-120 units daily for 2-3 weeks via IM or SC injection. Frequency and dose is determined depending on the severity of the disease and initial response from the treatment. Gradually discontinue the treatment by tapering the dose.

Intramuscular
Infantile spasms
Child: <2 years 75 units/m2/dose twice daily for 2 weeks. Frequency and dose is determined depending on the severity of the disease and initial response from the treatment. Gradually discontinue the treatment by tapering the dose (refer to detailed product guidelines).

Intramuscular, Subcutaneous
Allergic and inflammatory conditions of the eye, Diuresis in nephrotic syndrome, Rheumatic disorders, Symptomatic sarcoidosis, Systemic lupus erythematosus
Adult: 40-80 units every 24-72 hours via IM or SC injection. Dosage is individualised according to medical condition being treated. Frequency and dose is determined depending on the severity of the disease and initial response from the treatment. Gradually discontinue the treatment by tapering the dose (refer to detailed product guidelines).
Child: >2 years Same as adult dose.
Chống chỉ định
Hypersensitivity to porcine proteins. Scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, peptic ulcer, recent surgery, CHF, uncontrolled hypertension, primary adrenocortical insufficiency or hyperfunction, suspected congenital infections in infants. Co-administration with live or live attenuated vaccines. Not indicated for intravenous administration.
Thận trọng
Patient with hypertension, pre-existing psychiatric conditions (e.g. emotional instability psychotic tendencies), diabetes mellitus, gastrointestinal disease (e.g. diverticulitis, ulcerative colitis, risk of perforation, fresh intestinal anastomoses), gastrointestinal perforation, gastrointestinal bleeding, liver cirrhosis, myasthenia gravis, cataracts, glaucoma, risk factors for osteoporosis, thyroid disease (e.g. hypothyroidism), seizure disorder. Avoid abrupt withdrawal or rapid dose reduction. Renal and hepatic impairment. Children. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Adrenal suppression (e.g. hypothalamic-pituitary-axis suppression, Cushing’s syndrome), electrolyte disturbance, hypersensitivity reactions, immunosuppression, psychiatric disturbances (e.g. depression, euphoria, insomnia, irritability, mood swings, personality changes, psychotic manifestations), fluid retention, hypertension, hyperglycaemia, exacerbation of myasthenia gravis, increased intraocular pressure, open-angle glaucoma, cataracts, increased bone loss and osteoporotic fractures (long-term use).
Gastrointestinal disorders: Diarrhoea, vomiting.
General disorders and administration site conditions: Fever.
Infections and infestations: Infection.
Investigations: Weight gain.
Nervous system disorders: Seizures.
IM/Parenteral/SC: C
Chỉ số theo dõi
Monitor blood pressure, ECG, chest and spinal radiographs, cardiac function, weight, serum glucose, electrolytes, faecal blood and signs of infection during treatment and following discontinuation; signs and symptoms of adrenal insufficiency, Cushing’s syndrome and ocular infections. Monitor growth in children, bone mass density, and cataract formation following prolonged use.
Tương tác
May diminish therapeutic effect of inactivated vaccines.
Potentially Fatal: May enhance toxic effect and diminish therapeutic effect of live vaccines.
Ảnh hưởng đến kết quả xét nghiệm
May suppress wheal and flare reactions to skin test antigens.
Tác dụng
Description:
Mechanism of Action: Corticotropin is a naturally occurring hormone of the anterior lobe of pituitary gland. It stimulates the adrenal cortex to secrete cortisol, corticosterone, weakly androgenic substances, and aldosterone at a very limited extent.
Synonym: adrenocorticotrophic hormone (ACTH), adrenocorticotrophin, corticotrophin.
Onset: 3-12 hours (cortisol serum concentration).
Duration: 10-25 hours, up to 3 days.
Pharmacokinetics:
Absorption: IM: Rapidly absorbed. Approx 8-15 hours.
Excretion: Mainly via urine. Elimination half-life: 15 minutes.
Đặc tính

Chemical Structure Image
Corticotropin

Source: National Center for Biotechnology Information. PubChem Database. Corticotropin, CID=16132265, https://pubchem.ncbi.nlm.nih.gov/compound/Corticotropin (accessed on Jan. 22, 2020)

Bảo quản
Store between 2-8°C.
Phân loại MIMS
Hormon dinh dưỡng & các thuốc tổng hợp có liên quan
Phân loại ATC
H01AA01 - corticotropin ; Belongs to the class of ACTH. Used in anterior pituitary lobe hormone and analogue preparations.
Tài liệu tham khảo
Acton Prolongatum (Ferring). MIMS India. http://www.mims.com/india. Accessed 02/05/2018.

Anon. Corticotropin. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com/. Accessed 22/05/2018.

Anon. Corticotropin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/05/2018.

Buckingham R (ed). Corticotropin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/05/2018.

H.P. Acthar Repository Injection (Mallinckrodt ARD Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/05/2018.

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