부신 질환의 진단을 위한 혈액 검사

Blood Tests for the Diagnosis of Adrenal Diseases

Article information

Korean J Med. 2021;96(2):152-154

Publication date (electronic) : 2021 April 1

doi : https://doi.org/10.3904/kjm.2021.96.2.152

¹Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea

²Division of Endocrinology and Metabolism, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea

차선아¹, 문성대²

¹가톨릭대학교 의과대학 성빈센트병원 내분비내과

²가톨릭대학교 의과대학 인천성모병원 내분비내과

Korean J Med 2018;93:532-537. https://doi.org/10.3904/kjm.2018.93.6.532

다음과 같이 Table 내 오류가 있어 수정합니다.

Table 1.

Drugs that may affect the metabolism of plasma cortisol, aldosterone, renin, and catecholamines

Table 1.

Drugs that may affect the metabolism of plasma cortisol, aldosterone, renin, and catecholamines

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Table 1.

Drugs that may affect the metabolism of plasma cortisol, aldosterone, renin, and catecholamines

Adrenal hormone	Drug group	Drugs	Recommended withdrawal time
Plasma cortisol↓^a after overnight DST	Drugs that increase metabolism by inducing CYP3A4	Phenytoin, barbiturates, carbamazepine, rifampicin, alcohol, estrogen, mitotane	2 weeks [7]
Plasma cortisol↑^b after overnight DST	Drugs that decrease metabolism by inhibiting CYP3A4	Itraconazole, ritonavir, diltiazem, cimetidine	2 weeks
PAC/PRA ratio↓^a [19]	Angiotensin-converting enzyme inhibitors	Captopril, enalapril, fosinopril, lisinopril, ramipril	2 weeks
	Angiotensin receptor blockers	Losartan, valsartan, irbesartan, candesartan, telmisartan, eprosartan, olmesartan, fimasartan	2 weeks
	Dihydropyridine calcium channel blockers	Nifedipine, amlodipine	2 weeks
	Mineralocorticoid antagonists	Spironolactone, eplerenone	4 weeks
	Diuretics	Hydrochlorothiazide, furosemide, torsemide	4 weeks
PAC/PRA ratio↑^b [19]	β-blockers	Atenolol, bisoprolol, metoprolol, nebivolol, esmolol, propranolol, carvedilol, labetalol, nadolol	2 weeks
	NSAIDs	Ibuprofen, dexibuprofen, naproxen, fenoprofen, ketoprofen, loxoprofen, ketorolac, aceclofenac, diclofenac, piroxicam, meloxicam	2 weeks
	Renin inhibitor	Aliskiren	2 weeks
	Central agonists	Clonidine, α-methyldopa	2 weeks
Plasma catecholamines [20]	Alpha-blockers	Phenoxybenzamine, doxazosin	15 days
	Tricyclic antidepressants	Amitriptyline, imipramine, nortriptyline	3 days
	Antihistamine	Promethazine	3 days
	Sympathomimetics	Salbutamol, terbutaline, bambuterol	3 days
	Antipsychotics	Chlorpromazine, haloperidol, perphenazine, amisulpride, clozapine, olanzapine, quetiapine, risperidone	10 days-1 month for depot

DST, dexamethasone suppression test; CYP3A4, cytochrome P450 3A4; PAC, plasma aldosterone concentration; PRA, plasma renin activity; NSAIDs, nonsteroidal anti-inflammatory drugs.

Possibility of false-negative results.

Possibility of false-positive results.

Table 1.

Drugs that may affect the metabolism of plasma cortisol, aldosterone, renin, and catecholamines

Adrenal hormone	Drug group	Drugs	Recommended withdrawal time
Plasma cortisol↑after overnight DST	Drugs that increase metabolism by inducing CYP3A4	Phenytoin, barbiturate, carbamazepine, rifampicin, alcohol, mitotane	2 weeks [7]
Plasma cortisol↓after overnight DST	Drugs that decrease metabolism by inhibiting CYP3A4	Itraconazole, ritonavir, diltiazem, cimetidine	2 weeks
PAC/PRA ratio ↓[8]	Angiotensin-converting enzyme inhibitor	Captopril, Enalapril, Fosinopril, Lisinopril, Ramipril	2 weeks
	Angiotensin receptor blocker	Losartan, Valsartan, Irbesartan, Candesartan, Telmisartan, E prosartan, Olmesartan, Fimasartan	2 weeks
	Dihydropyridine calcium channel blocker	Nifedipine, Amlodipine	2 weeks
	Mineralocorticoid antagonist	Spironolactone, Eplerenone	4 weeks
	Diuretics	Hydrochlorothiazide, Furosemide, Torsemide	4 weeks
PAC/PRA ratio↑[8]	β-blockers	Atenolol, Bisoprolol, Metoprolol, Nebivolol, Esmolol, Propranolol, Carvedilol, Labetalol, Nadolol	2 weeks
	NSAIDs	Ibuprofen, Dexibuprofen, Naproxen, Fenoprofen, Ketoprofen, Loxoprofen, Ketorolac, Aceclofenac, Diclofenac, Piroxicam, Meloxicam	2 weeks
	renin inhibitor	Aliskiren	2 weeks
	central agonist	clonidine, α-methyldopa	2 weeks
Plasma catecholamines [9]	Alpha-blocker	Phenoxybenzamine, Doxazosin	15 days
	Tricyclic antidepressant	Amitriptyline, Imipramine, Nortriptyline	3 days
	Antihistamine	Promethazine	3 days
	Sympathomimetic	Salbutamol, Terbutaline, Bambuterol,	3 days
	Antipsychotic	Chlorpromazine, Haloperidol, Perphenazine, Amisulpride, Clozapine, Olanzapine, Quetiapine, Risperidone	10 days-1 month for depot

DST, dexamethasone suppression test; CYP3A4, cytochrome P450 3A4; PAC, plasma aldosterone concentration; PRA, plasma renin activity; NSAIDs, nonsteroidal anti-inflammatory drugs.