cosyntropin and Drug-Hypersensitivity

Several side effects of drugs observed in an office of a general practitioner are described. The cause of these side effects, their prevention and their treatment are discussed.

Topics: Adrenergic beta-Antagonists; Aged; Aged, 80 and over; Anaphylaxis; Anti-Inflammatory Agents, Non-Steroidal; Cosyntropin; Diclofenac; Digoxin; Drug Eruptions; Drug Hypersensitivity; Drug Interactions; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Nitrofurantoin; Penicillin G Procaine; Risk Factors; Verapamil

Subsequent use of an adrenocorticotropic hormone (ACTH) preparation may be considered in some instances in a patient who has demonstrated a suspected or proven allergic reaction to corticotropin on prior administration. We describe a patient with multiple sclerosis with a history of anaphylaxis to porcine ACTH in whom another course of treatment with ACTH was being considered. The patient had immediate cutaneous reactivity to porcine ACTH but not to the synthetic ACTH peptide, cosyntropin. With a test-dose schedule, we were able to uneventfully administer cosyntropin to the patient. The presence of serum IgE antibody directed against porcine ACTH and absence of IgE antibody against cosyntropin were demonstrated by ELISA technique, corroborating the skin test results. These studies are consistent with previous evidence that immediate hypersensitivity reactions to corticotropin are IgE mediated and support the value of skin testing in the clinical evaluation and management of known or suspected corticotropin hypersensitivity.

Topics: Adrenocorticotropic Hormone; Adult; Anaphylaxis; Animals; Cosyntropin; Drug Hypersensitivity; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin E; Skin Tests; Swine

Topics: Adrenocorticotropic Hormone; Adult; Antibodies; Cell Migration Inhibition; Cosyntropin; Diagnosis, Differential; Drug Hypersensitivity; Female; Humans; Lymphocyte Activation; Macrophages; Male; Methylprednisolone; Methylprednisolone Acetate; Middle Aged; Nervous System Diseases; Skin Tests

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Airway Obstruction; Asthma; Cosyntropin; Drug Hypersensitivity; Female; Humans; Male

The difficulties of long term treatment of chronic obstructive lung disease demand knowledge and use of every reasonable therapeutic regimen. In this study effectivity and side effects of Depot-ACTH (Tetracosactid) are presented. The main indications for the use of Depot-ACTH seem to be the uneffectiveness of usual therapy and the attempt of avoiding or reducing corticosteroids. The study confirms the excellent usefulness of Depot-ACTH which did not diminish during long-term application. The side effects are rare and mostly inferior. Only allergic reactions may be serious and must be accounted for.

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Asthma; Child; Cosyntropin; Diabetes Complications; Drug Hypersensitivity; Edema; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Pregnancy; Pregnancy Complications; Pulmonary Emphysema; Tuberculosis, Pulmonary

Topics: Adrenocorticotropic Hormone; Adult; Anaphylaxis; Animals; Antibody Formation; Asthma; Cosyntropin; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Injections, Intramuscular; Male; Swine; Zinc

Topics: Adrenocorticotropic Hormone; Adult; Aged; Cosyntropin; Drug Hypersensitivity; Female; Humans

Lymphocyte transformation to 1-24ACTH, as assessed by the incorporation of tritiated thymidine, has been demonstrated to be associated with severe adverse reactions occurring in patients receiving a Zn-linked 1-24ACTH preparation (Tetra cosactrin depot, 'Synacthen'). Antibodies measured with an isotope-binding assay occurred commonly in all patients receiving therapy and did not correlate with adverse reactions. Lymphocyte transformation with the 1-24ACTH polypeptide, a part of the naturally occurring ACTH molecule, has not been previously recorded. The significance of antibodies and cell-mediated immunity to this polypeptide hormone is discussed.

Topics: Adrenocorticotropic Hormone; Adult; Antibodies; Arthritis, Rheumatoid; Asthma; Child; Cosyntropin; Drug Hypersensitivity; Female; Humans; Immunity, Cellular; Lymphocyte Activation; Male; Middle Aged; Zinc

Topics: Adrenocorticotropic Hormone; Anaphylaxis; Asthma; Cosyntropin; Drug Hypersensitivity; Female; Humans; Male; Middle Aged

Topics: Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Biomedical Research; Cosyntropin; Dermatitis Herpetiformis; Drug Eruptions; Drug Hypersensitivity; Drug Therapy; Genetic Diseases, X-Linked; Immune Sera; Immunodiffusion; Leukemia, Hairy Cell; Lymphatic Diseases; Precipitin Tests; Severe Combined Immunodeficiency; Skin Tests; Toxicology

Topics: Adrenocorticotropic Hormone; Allergens; Biomedical Research; Cosyntropin; Drug Hypersensitivity; Skin Tests; Toxicology

Topics: Adrenocorticotropic Hormone; Cosyntropin; Drug Hypersensitivity; Fluorescent Antibody Technique; Humans; Immunodiffusion; Immunoelectrophoresis; Skin Tests; Toxicology