Management of Cushing's Syndrome

Edward M. DeSimone II, RPh, PhD, FAPhA; Paul C. Morales, PharmD; Jarek M. Vetter, PharmD

US Pharmacist

Abstract and Introduction

Introduction

Cushing's syndrome (CS) is a manifestation of symptoms that are precipitated by excessive cortisol production. CS is a rare but serious condition that can be fatal. There are several known causes of the syndrome, and treatments include surgery, radiation, and drug therapy. Diagnosing the specific origin of CS is complex and can be expensive, but diagnostic tests are essential in order to effectively manage a patient's therapy.

1 2 3 4 5 6 7

Next Section

Cite this: Management of Cushing's Syndrome - Medscape - Jun 01, 2010.

Table 1. Tests for Differential Diagnosis
Test	Results	Limitations
ACTH screening test	Differentiates ACTH-independent and -dependent CS	Complicated manipulation; ACTH is rapidly degraded by plasma proteases
High-dose DST	Differentiates ectopic or pituitary origin of tumor	60%-80% accuracy
CRH stimulation test	Differentiates ectopic or pituitary origin of tumor	Some ectopic tumors will react like pituitary tumors to CRH stimulation

ACTH: corticotropin; CRH: corticotropin-releasing hormone; CS: Cushing's syndrome; DST: dexamethasone suppression test.
Source: Reference ^[10].

Table 2. Relative Potencies of Glucocorticoids
Glucocorticoid	Equivalent Potency (mg)
Cortisone	25
Hydrocortisone	20
Prednisone	5
Prednisolone	5
Triamcinolone	4
Methylprednisolone	4
Dexamethasone	0.75
Betamethasone	0.6

Source: Reference ^[21].

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....

Management of Cushing's Syndrome

Abstract and Introduction

Introduction

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Most Popular Articles

Email This

Feedback