Levothyroxine medication, thyroid medication levothyroxine
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Pharmacology: Pharmacological action - filling shortage of hormones of a thyroid gland. Mechanisms of metabolic effects include receptor linkng with a genome, changes of an oxidizing exchange in mitochondrions and regulation of a flow of substrates and cations out of and in a cell. In small doses has anabolic effect stimulates growth and development in averages, increases need of fabrics for oxygen, regulates a metabolism of proteins, fats and carbohydrates, increases functional activity of cardiovascular system and TsNS, in big oppresses development thyrotropin-rileasing and thyritropic hormones, levothyroxine medication
80% of a dose are soaked up in a small bowel, time of achievement of C_max about 6 h. Linkng with proteins of plasma more than 99%. Metabolic Cl 1,2 l of plasma a day, T_1/2 about 8 days. Biotransformation consists in consecutive deiodinating (including T_3 leading to education) mainly in a liver, muscles and a brain, and also a konjyugirovaniye with glyukuronaty and sulfate in a liver, levothyroxine medication, thyroid medication levothyroxine
The clinical effect at a hypothyroidism is shown in 3-5 days. The early diffusion hyperplastic craw decreases or disappears within 3-6 months, at late nodal stages the considerable reduction of the sizes of a thyroid gland is noted only in 30% of cases, but almost at all patients its further growth is prevented, levothyroxine synthroid, levothyroxine overdose, levothyroxine ingredients
Indications to use levothyroxine medication
Use: Hypothyroid conditions of various etiology (including caused by surgical or medicamentous influence), supressivny thyroid therapy of a simple (nontoxic) craw, an autoimmune thyroiditis of Hashimoto, a multinodal craw, thyreostatic treatment of a hyperthyroidism (complex therapy after achievement of an euthyroid state, the tireotropinzavisimy high-differentiated papillary or follicular carcinomas of a thyroid gland (complex treatment), prevention of recurrence of a craw after a resection, carrying out the supressionny scintigraphic test of a thyroid gland.
Contraindications: Hypersensitivity, an uncured thyrotoxicosis, an acute myocardial infarction, stenocardia, myocarditis, takhisistolichesky disturbances of a rhythm, heart failure, a serious idiopathic hypertensia, neskorrigirovanny dysfunction of bark of adrenal glands, advanced age (65 years are more senior).
Side effects: Tachycardia, disturbances of a rhythm, pain behind a breast, a tremor, concern, sleeplessness, a hyperhidrosis, decrease in body weight, diarrhea, an alopecia, dysfunction of adrenal glands (at a pituitary or hypothalamic hypothyroidism), disorders of function of kidneys at children.
Interaction: Reduces effect of insulin and peroral antidiabetic drugs, cardiac glycosides, strengthens indirect anticoagulants, tricyclic antidepressants. Colestyraminum, kolestipol, a hydroxide of aluminum reduce plasma concentration due to braking of absorption in intestines.
Phenobarbital and Phenytoinum accelerate metabolic clearance, without increasing a share of free T_3 and T_4 in blood. Estrogen increases concentration of the fraction connected with thyreoglobulin (efficiency decreases). Proteinaceous binding is changed by anabolic steroids, asparaginase, Clofibratum, furosemide, salicylates, Tamoxifenum.
Amiodaronum, aminoglutetimid, aminosalicylic acid, Etioniamidum, anti-thyroid drugs, thyroid medication levothyroxine, beta adrenoblockers, carbamazepine, Chlorali hydras, diazepam, levodopa, dopamine, Metoclopramidum, lovastatin, somatostatin, etc. can change levels thyroid and thyritropic hormones, as a rule, influencing synthesis, secretion, distribution, a metabolism, action or elimination of thyroid hormones or changing secretion of TTG.
Overdose levothyroxine medication
Symptoms: the thyrocardiac crisis sometimes delayed for several days after reception.
Treatment: purpose of beta adrenoblockers, in/in introduction of corticosteroids, a plasma exchange.
Dosage and route of administration levothyroxine medication
Route of administration and doses: Inside, in the morning, on an empty stomach, washing down with a small amount of liquid. At a hypothyroidism an initial dose of 25-100 mkg a day, with gradual increase (on 25-50 mkg each 2-3 weeks) to supporting 125-250 mkg a day, after operation for a malignant tumor of a thyroid gland to 300 mkg a day.
To children the initial dose of 12,5-50 mkg supporting 100-150 mkg a day.
At complex treatment of a hyperthyroidism 5-100 mkg a day.
For carrying out the supressionny test within 14 days of 200 mkg a day or 3 mg of 1 times in 7 days prior to a repeated stsintigramma.
Euthyroid craw and prevention of its recurrence after a resection: adult 75-200 mkg a day, to children 12,5-150 mkg a day.
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