The adrenal cortex produces glucocorticoids (cortisol) and mineralocorticoids
(aldosterone). Corticosteroids promote sodium retention and potassium excre-
tion. Corticotropin (Acthar) is an ACTH drug that is used to diagnosis adrenal
gland disorders.
Corticotropin (Acthar) is also used to treat adrenal gland insufficiency and as
an anti-inflammatory drug in the treatment of allergic reactions such as anaphy-
laxis shock.
ACTH given intravenously increases the serum cortisol levels in 30 to
60 minutes if the adrenal gland is properly functioning. ACTH will eventually
stimulate cortisol production if pituitary insufficiency causes steroid deficiency.
Table 21-2 shows the effects of an adrenal gland that produces too much
(hypersecretion) or too little hormone (hyposecretion). Adrenal hyposecretion is
called Addison’s disease and hypersecretion is called Cushing’s syndrome.
ACTH is a hormone released by the anterior pituitary gland that influences the
glucocorticoids that are secreted by the adrenal gland. Glucocorticoids affect carbo-
hydrate, protein, and fat metabolism in addition to muscle and blood cell activity.(^388) CHAPTER 21 Endocrine Medications
Body System Hyposecretion Hypersecretion
Metabolism
Glucose Hypoglycemia Hyperglycemia
Protein Muscle weakness Muscle wasting; thinning of the
Fat skin; fat accumulation in face, neck,
and trunk (protruding abdomen,
buffalo hump); hyperlipidemia;
high cholesterol
Central Nervous Apathy, depression, fatigue Increased neural activity; mood
System elevation; irritability; seizures
Gastrointestinal Nausea, vomiting, Peptic ulcers
abdominal pain
Cardiovascular Tachycardia, hypotension, Hypertension; edema; heart failure
cardiovascular collapse
Eyes None Cataract formation
Fluids and Hypovolumia; hyponatremia; Hypervolemia; hypernatremia;
Electrolytes hyperkalemia hypokalemia
Blood cells Anemia Increased red blood cell count and
neutrophils; impaired clotting
Table 21-2. Effects of adrenal hyposecretion and hypersecretion.