Skydliaukės hormonų preparatai

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Skydliaukės hormonų preparatai Jokūbas Liutkus MF Medicina IIIk. 1gr. Vaida Banislauskaitė Laurita Briedytė Eglė Deltuvaitė Akvilė Gaupšaitė

Atstovai Levotiroksinas (T4) Liotironinas (T3) Liotrix (T3 & T4) t1/2 ~ 7d. Liotironinas (T3) Liotrix (T3 & T4) Džiovinta skydliaukė

Farmakokinetika (T4) Absorbcija dvylikapirštėje ir klubinėje žarnose Susiję faktoriai (pvz. maistas) Biologinis prieinamumas per os ~ 70% ↓ esant miksedemai (hipotiroidizmas) Metabolizmas greitėja: Hipertiroidizmas Vaistai, indukuojantys kepenų fermentus (pvz. fenobarbitalis, rifampinas) Nėštumas, estrogenai gali didinti TBG kiekį

Farmakodinamika Atsiskyrę nuo TBG, per nešiklius patenka į ląstelę T4 verčiamas T3 T3 patenka į branduolį, prisijungia prie T3 receptoriaus Receptoriai α ir β tipų Veikia transkripciją Ląstelėje daugėja Na+-K+-ATPazės Greitėja metabolinės reakcijos ↑ adenilatciklazės aktyvumas, daugėja β receptorių ir ↑ jų signalų amplifikacija

Klinikinis vartojimas Levotiroksinas (T4) – hipotiroidizmas, pakaitinė hormonų terapija Liotironinas (T3) – trumpalaikei TSH supresijai; miksedeminė koma Liotrix (T3 & T4) Džiovinta skydliaukė

Nepageidaujamas poveikis Tirotoksikozei būdingi požymiai Metabolizmas: svorio kritimas CNS: nervingumas, agitacija Inotropinis ir chronotropinis poveikis širdies veiklai; aritmijos Karščio netoleravimas Tremoras

šaltiniai Katzung BG, Trevor AJ. Basic & Clinical Pharmacology. 13th ed. New York: McGraw-Hill; 2015 Whalen K, Finkel R, Panavelil TA. Lippincott Illustrated Reviews: Pharmacology. 6th ed. Philadelphia: Wolters Kluwer; 2015 Hall JE, Guyton AC. Guyton and Hall Textbook of Medical Physiology. 13th ed. Philadelphia: Elsevier; 2016