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Directions for Administering ACTH

ACTH, adrenocorticotropic hormone, is produced by the pituitary gland, which stimulates the adrenal gland to produce adrenocortical hormones. These hormones affect metabolism of glucose, proteins and fats. Several conditions can result in a deficiency of either ACTH or corticosteroids, which ACTH stimulates. The general condition is known as adrenal insufficiency. Symptoms may include weakness, fatigue, low blood pressure, decreased libido, and/or loss of axillary or pubic hair.

There are two general categories of adrenal insufficiency, primary and secondary. Primary adrenal insufficiency occurs when the adrenal glands do not make enough steroids, but there is adequate ACTH. Secondary adrenal insufficiency occurs when there is a problem with the pituitary gland resulting in a decreased amount of ACTH, thus there is a decrease in the amount of steroids produced by the adrenal gland. The test to differentiate between the two is called a cosyntropin test, which requires administration of ACTH. This test should be performed under medical care given by a physician or nurse.

Things You'll Need

  • Cosyntropin 25 units
  • Needle 22 or 24 gauge
  • Syringe
  • Alcohol swab
  • Adhesive bandage
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Instructions

  1. Administration of ACTH to differentiate between two types of Adrenal Insufficiency

    • 1

      Check your blood cortisol level just prior (within one to two hours) to cosyntropin administration via a blood test.

    • 2

      Draw out 25 units or 0.25mg of cosyntropin, ACTH, into a syringe.

    • 3

      Wipe the area of injection with an alcohol swab. If you are administering the cosyntropin into an accessed intravenous line, then wipe the hub of the intravenous line with the alcohol swab. If you are administering the cosyntropin intramuscularly, then wipe the area of skin where you plan to inject the consyntropin.

    • 4

      Administer the injection either via an intravenous catheter line or intramuscularly. If injecting intramuscularly use either the deltoid region or the gluteal region.

    • 5

      Place an adhesive bandage over the area if the injection was given intramuscularly.

    • 6

      Check the cortisol level 30 minutes and 60 minutes after the administration of consyntropin via a blood test.

    • 7

      Discuss with your physician the results of the test.

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