Metyrapone test dose

Investigation Protocol

Indications

Assessment of biochemical response to a test dose of metyrapone or other drug in Cushing’s syndrome.

Preparation

The patient may eat and drink normally prior to the test. Patients can take their usual medication before attending, but are asked to bring in all their usual medication for this to be documented.

Procedure

Cannulation may be offered. Insert cannula gauge 20 with a three-way tap, and using the vacutainer connector system or a syringe fill one plain clotted tube for each sample taken. Clearly mark with the patient’s details, date and time of sample.

The first sample is taken at 9am. After this, the test drug e.g. metyrapone 750mg, is administered. Further samples are then taken at 10am, 11am, midday and 1pm. Where requested, samples will also be taken at 3pm and 5pm. Clearly mark the patient’s details, date and time on each bottle.

Samples should be sent for cortisol in all cases, and for cortisol and 11 deoxycortisol when requested, in patients with pituitary dependent Cushing’s disease.

Additional blood should be drawn into an EDTA tube for ACTH with the first sample where requested. This sample will need to be labelled, then centrifuged, separated and frozen before transport to the laboratory.

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Patient information sheet

Metyrapone test dose

Your doctor has referred you to have a series of blood tests performed over a day. This is to see if you are likely to respond to a new medication for your Cushing's syndrome.

We will be taking a sample of blood at 9am, 10am, 11am, midday and 1pm. You will be resting in a reclining chair in the unit throughout the test. You may eat and drink as normal on the day of the test. If you are in the unit over the lunch period you will be offered something to eat. You do not have to stay in the unit for the whole day but you may do so if you choose.

You may take all your usual medication as normal on the day of the test, but please bring this with you for us to document during the test. However, if you take the contraceptive pill, hormone replacement therapy, or steroid tablets, nasal drops, inhalers, skin cream, or have recently had a joint injection, it is important that you inform us before the test date. You can contact us either by writing to the address at the top, or by phoning the number given at the end of this sheet.

You may wish to bring a book or magazine to read. We do have a radio, or you can access Patientline; alternatively you may like to bring your own personal radio/cd player (please bring your own headphones). You may bring someone to stay with you during the test but there is not enough space for more than one person.

Children are discouraged, as this can be disruptive to other patients. However, if this poses a particular problem for you please discuss this with the senior nurse in the unit. You should be able to undertake normal activities after the test is finished and it should not interfere with your ability to drive home. 

If you have any queries about the test, please contact: 

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