Metrika

  • citati u SCIndeksu: 0
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[]
  • posete u poslednjih 30 dana:10
  • preuzimanja u poslednjih 30 dana:0

Sadržaj

članak: 8 od 15  
Back povratak na rezultate
2010, vol. 60, br. 2, str. 149-157
Medikamentna terapija poremećaja funkcije štitaste žlezde
Univerzitet u Beogradu, Medicinski fakultet
Sažetak
Terapija hipotireoze predstavlja nadoknadu tiroidnih hormona primenom levotiroksina. Terapija se započinje punom dozom leka. Izuzeci su stare osobe, osobe sa srčanim oboljenjima i osobe sa veoma teškom hipotireozom. Optimalna supsitucija je postignuta kada je koncentracija TSH između 0.5 i 2 mU/L. Za lečenje hipertireoze koriste se tionamidi: propiltiouracil (PTU), metimazol (tiamazol) i karbimazol. Karbimazol se metaboliše u metimazol. Tionamidi se akumuliraju u štitastoj žlezdi. Oni sprečavaju oksidaciju i organifikaciju joda u tiroidei i time blokiraju sintezu tiroidnih hormona. Tionamidi indukuju remisiju autoimune hipertireoze. To je posledica imunosupresije koja se prvenstveno odigrava u samoj štitastoj žlezdi. Metimazol je lek izbora za terapiju hipertireoze. Jedini izuzetak je hipertireoza u trudnoći, jer je upotreba metimazola udružena sa teratogenim efektima. Teratogeno dejstvo PTU nije dokazano. PTU je verovatno bezbedan tokom dojenja. Agranulocitoza tokom terapije tionamidima se javlja u 0.35% osoba. Hepatotoksičnost je drugi ozbiljan problem. Skorašnja literatura ukazuje na visok rizik hepatotoksičnosti kod primene PTU, naročito kod dece. 'Block and replace' protokol predstavlja primenu tireosupresiva i levotoroksina. Pacijenti lečeni ovim protokolom imaju manje ranih recidiva, ali više neželjenih efekata. Ovaj protokol omogućuje veći komfor bolesnika jer je potreban manji broj kontrola.
Reference
*** (2006) Drug database. u: de Groot LJ, Jameson L [ur.] Endocrinology, Philadelphia: Elsevier Saunders
*** (2010) British National Formulary. [14. 04. 2010.]; 59
AACE Thyroid Task Force (2006) American association of clinical endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. www.aace.com/pub/pdf/guidelines/hypo_hyper.pdf
Abraham, P., Avenell, A., McGeoch, S.C., Clark, L.F., Bevan, J.S. (2010) Antithyroid drug regimen for treating Graves hyperthyroidism. Cochrane Database Syst Rev, CD003420
American Thyroid Association (2004) Joint statement on the U.S. Food and Drug Administration s decision regarding bioequivalence of levothyroxine sodium. Thyroid, 14(7): 486
Bonaci-Nikolic, B., Nikolic, MM., Andrejević, S., Zoric, S., Bukilica, M. (2005) Antineutrophil cytoplasmic antibody (ANCA)-associated autoimmune diseases induced by antithyroid drugs: comparison with idiopathic ANCA vasculitides. Arthritis Research & Therapy, vol. 7, br. 5, str. R1072-R1081
Cooper, D.S. (2005) Antithyroid drugs. N Engl J Med, 352(9): 905-17
Davies, T.F., Larsen, P.R. (2003) Thyrotoxicosis. u: Larsen P.R., Kronenberg H.M., Melmed S., Polonsky K.S. [ur.] Williams Textbook of Endocrinology, Philadelphia: Saunders, 374
di Girolamo, G., Keller, G.A., Los, S.A.R., Schere, D., Gonzalez, C.D. (2008) Bioequivalence of two levothyroxine tablet formulations without and with mathematical adjustment for basal thyroxine levels in healthy Argentinian volunteers: a single-dose, randomized, open-label, crossover study. Clinical therapeutics, 30(11): 2015-23
FDA (2009) Information for healthcare professionals: Propylthiouracil-induced liver failure. updated 06/04
Fish, L.H., Schwartz, H.L., Cavanaugh, J., Steffes, M.W., Bantle, J.P., Oppenheimer, J.H. (1987) Replacement dose, metabolism, and bioavailability of levothyroxine in the treatment of hypothyroidism: Role of triiodothyronine in pituitary feedback in humans. N Engl J Med, 316(13): 764-70
Hennessey, J.V., Malabanan, A.O., Haugen, B.R., Levy, E.G. (2010) Adverse event reporting in patients treated with levothyroxine: Results of the pharmacovigilance task force survey of the American thyroid association, American association of clinical endocrinologists and the endocrine society. Endocr Pract, Feb 11:1-41
Martindale (2007) The complete drug reference. London: Pharmaceutical Press, CD
McDermott, M.T. (2009) In the clinic: Hypothyroidism. Ann Intern Med, Dec 1;151(11):ITC61
Mcgregor, A.M., Petersen, M.M., Mclachlan, S.M., Rooke, P., Smith, B.R., Hall, R. (1980) Carbimazole and the autoimmune response in Graves' disease. N Engl J Med, 303(6): 302-7
Mitsiades, N., Poulaki, V., Tseleni-Balafouta, S., Chrousos, G.P., Koutras, D.A. (2000) Fas ligand expression in thyroid follicular cells from patients with thionamide-treated Graves' disease. Thyroid, 10(7): 527-32
Oppenheimer, J.H., Braverman, L.E., Toft, A., Jackson, I.M., Ladenson, P.W. (1995) A therapeutic controversy: Thyroid hormone treatment: When and what?. J Clin Endocrinol Metab, 80(10): 2873-83
Rivkees, S.A., Mattison, D.R. (2009) Ending propylthiouracil-induced liver failure in children. N Engl J Med., Apr 9;360(15):1574-5
Salvi, M., Girasole, G., Pedrazzoni, M., Passeri, M., Giuliani, N., Minelli, R., Braverman, L.E., Roti, E. (1996) Increased serum concentrations of interleukin-6 (IL-6) and soluble IL-6 receptor in patients with Graves' disease. J Clin Endocrinol Metab, 81(8): 2976-9
Smith, T.J., Bahn, R.S., Gorman, C.A. (1989) Connective tissue, glycosaminoglycans, and diseases of the thyroid. Endocrine Reviews, 10(3), 366-91
Sobrinho-Simões, M., Máximo, V., Rocha, A.S., Trovisco, V., Castro, P., Preto, A., Lima, J., Soares, P. (2008) Intragenic mutations in thyroid cancer. Endocrinology and metabolism clinics of North America, 37(2): 333-62, viii
Sonnet, E., Massart, C., Gibassier, J., Allannic, H., Maugendre, D. (1999) Longitudinal study of soluble intercellular adhesion molecule-1 (ICAM-1) in sera of patients with Graves' disease. Journal of endocrinological investigation, 22(6): 430-5
Todd, C.H. (2009) Management of thyroid disorders in primary care: Challenges and controversies. Postgrad Med J., Dec;85(1010):655-9
Tsatsoulis, A., Vlachoyiannopoulos, P.G., Dalekos, G.N., Johnson, E.O., Moutsopoulos, H.M. (1995) Increased serum interleukin-1 beta during treatment of hyperthyroidism with antithyroid drugs. Eur J Clin Invest, 25(9): 654-8
Weetman, A.P. (1994) The immunomodulatory effects of antithyroid drugs. Thyroid, 4(2): 145-6
Wiersinga, W.M. (2006) Hypothyroidism and Myxedema Coma. u: de Groot LJ, Jameson L. [ur.] Endocrinology, Philadelphia: Elsevier Saunders, 5 ed.p. 2081-100
 

O članku

jezik rada: srpski
vrsta rada: stručni članak
objavljen u SCIndeksu: 22.06.2010.