Umuthi 'El-thyroxine ": yokusetshenziswa, analogs, ukubuyekezwa

Izidakamizwa "Al-thyroxine" - zokwenziwa yegilo i-hormone, thyroxine Analogue we zemvelo. Ngemva kokuthola lezi nomuthi kuyinto ukuguqulwa olungaphelele thyroxine ukuba triiodothyronine, iodo hormone ehilelekile zonke izinqubo umzimba futhi has nethonya elikhulu imisebenzi kwezitho eziningi. Umuthi isetshenziswa Ezimweni lapho kakhulu ziyancipha umsebenzi yegilo.

Isicelo se-nomuthi ukhonjiswa emva kokuphela ukususwa indlala yegilo nezicubu yayo ihlumela lapho indlala umsebenzi is hhayi kahle. Ngezinye izikhathi imithi ezinqunyiwe kubantu abaye babhekana nesimo aphakeme umsebenzi yegilo, kodwa qala ngokwenza yokwelapha ukucindezela uketshezi hormone iodine-equkethe. In iziguli ezinjalo, ngemva isicelo "El-thyroxine" ukuyiveza TTG inqubo isizukulwane okuyinto ehilelekile synthesis thyroxine.

Ifomu ukukhululwa izidakamizwa izithako

"El-thyroxine" itholakala amaphilisi. Ingqikithi esebenzayo levothyroxine sodium. Ukwakheka izidakamizwa zingaletha inombolo ehlukile izingxenye eziyisisekelo, umuthi efanelekayo udokotela. izithako Asizayo ethulwa sodium isitashi glycolate, i-calcium hydrogen phosphate dihydrate, eside chain glycerides ngokwengxenye, dextrin futhi microcrystalline cellulose. Ezahlukene abakhiqizi isakhiwo izithako asizayo ingase ihluke kancane.

Pharmacodynamics, pharmacokinetics, "El-thyroxine"

Isithako asebenzayo zomuthi kanye thyroxine, okuyinto okukhipha kwenzeka emzimbeni, enza umsebenzi ofanayo. "El-thyroxine" kunomthelela ukuzinza we izinqubo umzimba, izinqubo yentuthuko nokukhula. Isenzo zomuthi kunqunywa okuqukethwe ketshezi asebenzayo. Ukusetshenziswa ngemithamo emincane "El thyroxine" kuholela ukuthuthukiswa umphumela Anabolic, ephakeme - udinga ukwandisa cell nezicubu-mpilo isidingo, lo ukukhuthazwa oxidative izinqubo, kuyashesha umzimba nokwaphuka carbohydrate, amaprotheni, amafutha. Ngaphezu kwalokho, ngezinye ebulilini izidakamizwa oyenza ohlelweni sezinzwa, uhlelo senhliziyo nemithambo yegazi.

I nomuthi iqala ukwenza emva emva isicelo sokuqala mayelana kwezinsuku ezinhlanu. Kwaphela izinyanga ezintathu kuya kweziyisithupha ukwelashwa okuqhubekayo kungenzeka ukuba balahle goiter ngokukhukhumala kwentamo noma sinciphise ubukhulu bayo.

Absorption senzeka ikakhulu emathunjini amancane ngenxa kokuthola ithebhulethi bazila ukudla akuyona ezingaphezu kuka-80%, nokusetshenziswa ukudla kuyehla. exhunywe kahle amaprotheni oketshezi olungenambala olusegazini, "El-thyroxine", isitatimende kubonisa ukuthi uxhumano cishe 100%, ngakho izidakamizwa akuphazamisi noma hemodialysis noma hemoperfusion.

Ubuningi esiphezulu ingxenye eyinhloko iqinile emzimbeni ngemuva kwamahora amahlanu ngemva ukungenisa isidakamizwa. ukususwa kwengxenye zomuthi ezigulini kwenzeka ngezindlela ezahlukene, kuya ngokuthi izinga lama-hormone yegilo emzimbeni.

I-hypothyroidism kususwe wenziwa kwezinsuku eziyisishiyagalolunye noma eziyishumi, ne euthyroid - ibe yisithupha noma isikhombisa, thyrotoxicosis isigamu-ukuphila ageleza ngokushesha - ngezinsuku ezintathu noma ezine.

Cishe ingxenye eyodwa kwezintathu imithi umthamo isakhi esiyinhloko zibekwe isibindi, kuyilapho siphawula ukuxhumana okusheshayo nge-thyroxine okuyinto ekhona igazi. Kwenzeka kumiswa metabolites ngemva ukungenisa amaphilisi "El thyroxine". Yokusetshenziswa zemibiko umzimba eyinhloko ingxenye izidakamizwa wenziwa ebuchosheni, imisipha, izinso kanye esibindini. Excretion of metabolites ezivezwa izinso namathumbu.

Izinkomba ngokusetshenziswa ukulungiswa "El thyroxine"

ukwelashwa Ukushintshwa kusekelwe ekusetshenzisweni kwale izidakamizwa ebekiwe iziguli uthi hypothyroid of etiologies ezahlukene, t. H. Hypothyroid (primary, secondary) ezenzeka emuva kokuhlinzwa futhi sicasukile ngu reception izindlela okuyinto akhiwa radioiodine . "El-thyroxine" imfundo on isicelo ikuvumela ukwabela kulezi zimo ezilandelayo:

• izifo Cerebro-hypophyseal;
• Hypothyroidism azalwa naso futhi wathola;
• goitre euthyroid;
• isifo Hashimoto sika, Graves 'disease ivame (inqubo yokwelapha ngokwamaqiniso eziyinkimbinkimbi);
• ne izimpawu ezihambisana nokukhuluphala noma i-hypothyroidism cretinism, ephelezelwa izici ezifanayo;
• Hyperplasia euthyroid (ukwelashwa);
• yansukuzonke goiter nodular ngemva resection e iziyaluyalu ukungabi indlala (amaphilisi asetshenziswa njengendlela nomuthi prophylactic);
• isimila umdlavuza (esikhundleni kanye therapy suppressive);
• neoplasms, izimpawu njengoba umahluko kakhulu, ama-hormone, abe uhlobo ebulalayo.

Imithi esetshenziswa ukwenza ukuhlola. Ngezinye izikhathi abantu "El thyroxine" neminye ukungabi khona izinkinga indlala yegilo, kodwa odokotela awumuhle ukusetshenziswa nomuthi ngenjongo ezinjalo.

Izimo ukwamukela izidakamizwa, "El-thyroxine"

I nomuthi akuyona iqondiswa iziguli luvelo izingxenye zalo. Izimo zihlanganisa:

• isilethikusebenza (isigaba acute);
• egijima gipokortitsizm ngaphambilini ingelashwa noma thyrotoxicosis;
• ukuvuvukala imisipha yenhliziyo imvelo acute;
• galactosemia lezinceku;
• ngalesi sifo, okuyinto ephazamisa ukumuncwa emathunjini;
• lactase ukuntula.

Umuthi isetshenziswa ngokuqapha in iziguli ngifundise ngesifo sikashukela, lapho kunzima egeleza hypothyroidism, okuyinto isikhathi eside engakaze aphathwa ngayo, futhi yizifo ezihlobene nokungabikho izilonda senhliziyo:

• sredtsa isifo senhliziyo yenhliziyo;
• nomfutho wegazi ophezulu;
• arrhythmia;
• isilethikusebenza (umlando);
• isifo sokuqina kwemithambo yegazi.

Uma isiguli amanye alawa izifo, umthamo kuyehla noma Analogue ekhethiwe.

Ukwelapha

Phakathi ukwelashwa, indlela "El-thyroxine" ngemithamo akhethiwe ngamunye isiguli ngasinye kusekelwe ebufakazini. Tablets musa ukuhlafuna, isiphuzo esiswini esingenalutho, imizuzu engu-30. ngaphambi kokudla. Iziguli izifo kohlelo eziphathelene nenhliziyo ifinyelele iminyaka engamashumi ayisihlanu nanhlanu ku-1 kg isisindo inikezwa esiphezulu 0.9 mg zomuthi. Zonke ezinye esikhonjiswa kusuka 1.6 .mu.g 1.8. Ngesikhathi besanda kuqala ukwelashwa, umthamo watusa zomuthi ngoba Ezigulini ezine-hypothyroidism zimi kanje:

• Iziguli unezinkinga esimiso senhliziyo nemithambo yegazi, umuthi ebekiwe kusukela 75 mcg 150, okuhambelana umthamo wansuku zonke.
• Ngo izilonda zenhliziyo, kanye iziguli esezikhulile iqondiswa izidakamizwa isamba esingu-25 g. Ngemva kwezinyanga ezimbili umthamo lakhuphuka lafika ku-50 mcg. Kamuva, le ipharamitha ushintsho nge isikhawu esifanayo, okwandisa 25 g, kuze kube yilapho kunqunywa inani elikhulu ekwakhiweni kanye TSH hhayi evamile.

Indlela yokwenza "El-thyroxine" ezimweni ezahlukene, kubalulekile ukuqaphela udokotela. Uma isimo izitsha inhliziyo Ubangwa, kubalulekile ukuba bayihlole kabusha indlela ekwelapheni izifo yisimiso senhliziyo nemithambo yegazi.

Lapho i-hypothyroidism azalwa naso uhlobo umthamo zomuthi ikhethwa ngokobudala. Iziguli ezincane kunazo zonke (izinyanga kuze kufinyelele 6) iqondiswa 25 micrograms izidakamizwa, kodwa akukho ngaphezu kuka-50, umthamo wansuku zonke obudingekayo kusukela micrograms kilogram per 10 kuya ku-15. Izingane ezingaphansi kweminyaka engu-akukho ngaphezu konyaka 1, ukhombe mg 50 per kg. Uma engu-isiguli e uhla iminyaka zi oyedwa kuya kwabahlanu, umthamo ubuncane 75 mcg, kodwa akukho micrograms ezingaphezu kuka-100. Ngemva kweminyaka eyisithupha yokuzikhandla yobudala (izingane ezingaphansi kweminyaka engu-12) ovunyelwe ukusebenzisa izimali mcg 100 esingeqile umthamo 150 mcg. Nezinye izingane oyifunayo umthamo kuyakhethwa ku ezahlukene micrograms 100 200.

Phakathi ukwelashwa, imithi, "El-thyroxine" njengoba kwabikwa kuyi yokusetshenziswa izingane ezingaphansi kweminyaka ezintathu umthamo wansuku kusho ukunikeza esisodwa. Ngemva izidakamizwa ukuphatha yokudla kungenziwa kwenziwe isigamu sehora. Ekwelapheni izingane ezincane ezisetshenziswa isixazululo okulungiselelwe kusuka amaphilisi.

Ezimweni eziningi, abantu abaphethwe i-hypothyroidism, ukuphuza imithi impilo yakho yonke. Labo wembula thyrotoxicosis, ngemva ukuthuthukiswa euthyroid isimo "thyroxine" belulekwa ukuthi kusetshenziswe ngokuhlanganyela antitireoidinymi kusho isikhathi kunqunywa udokotela.

Ukusetshenziswa kwezidakamizwa kwesisindo

Ukuqeda isisindo okweqile usebenzisa 50 micrograms ngelanga kusho. I nsuku zonke umthamo ukusetshenziswa izinyathelo ezimbili okumelwe kwenziwe ekuseni. Bekanye izindlela "El thyroxine" ukuthatha β-blocker ngezilinganiso ezisuselwe imvamisa ishayela. Ngo umthamo okwengeziwe yokukhuphuka kuvunyelwe "thyroxine" 150 micrograms. Khulisa umthamo kancane kancane, emva ukwanda kwe-reception kusho uhlukaniswe kathathu. Kulokhu, indlela wesibili kumele kwenziwe kungakapheli 18:00. Futhi, ukwandisa umthamo β-blocker, imali edingekayo izidakamizwa ikhethwa ngamunye, uphumule kwenhliziyo kufanele ibe uhla kusuka 60 kuya 70 amabhithi ngeminithi.

Ngezinye izikhathi kudingeka wehlise umthamo kusho "Al-thyroxine". Imiphumela engemihle kubonise isidingo sokuya ukhansele noma ukunciphisa umthamo izidakamizwa. Inkambo kufanele kuhlale cishe inyanga, ungathathi imithi isikhathi eside kunaleso amasonto ayisikhombisa.

Musa evele ukulahla ukusetshenziswa kwezidakamizwa, ukuqedwa yenziwa kancane kancane, elokhu enciphisa umthamo ukuze wemaviki lamabili ngezikhawu. Lapho uhudo kuyinto okwengeziwe isiphuzo ejenti "Loperamide" e amaphilisi elilodwa noma amabili ngosuku. Phinda Yiqiniso okuhloswe ngazo ukunciphisa isisindo, kungaba Ngemva kwamasonto amathathu noma amane.

Imiphumela engemihle

ukusabela ezithile ezingezinhle ingabuye yenteke ngesikhatsi ukwelashwa nge "Al-thyroxine". Imiphumela engemihle uma usebenzisa izidakamizwa ngesikhathi ngemithamo ezinconyiwe ezingajwayelekile kakhulu. Ngenxa isifiso yanda kungase kwandise isisindo, izinwele kungaba fall out, kungenzeka ukuvela izinkinga kanye nezinso. Izingane abanesifo sokuwa futhi babe sengozini enkulu yokufa nokuquleka, isifo lungase lube lukhulu ngokwengeziwe uma idlule isethi umthamo "thyroxine". In the ukwelashwa nge ebulilini kungenzeka ukuthi ukuthuthukiswa izimpawu ka-hyperthyroidism.

Phakathi kwezinye side effects - nokukhathazeka, yokukhathazeka, ukubukeka esitho liqhaqhazela, inkinga yokungalali kahle, izimpawu arrhythmia futhi tachycardia. Futhi, kungase kube kwesisindo nokuthuthukiswa yesifo sohudo, khona ukuhlanza. Mhlawumbe ukujuluka, khona izimpawu ezihambisana ngokuhlasela pectoris angina. Ezinye iziguli dermatitis nomzimba. With ukuthuthukiswa ukusabela ezingezinhle zomzimba ephansi umthamo "thyroxine" noma ukhansele okwesikhashana izidakamizwa futhi kamuva zisebenzisa umthamo ezincane.

Ingxube izidakamizwa notshwala

Ngokuvamile, umthamo owodwa we-esincane utshwala inqaba ongaphakeme ayinalo ithonya endleleni umphumela we-ejenti "Al-thyroxine". Izibuyekezo ukukhombisa ukuthi ukuphuza utshwala ngesikhatsi ukwelashwa kungase kuphela labo bantu abangenalo izinkinga nemithambo yegazi kanye inhliziyo. Kwezinye izimo, le inhlanganisela yemithi ngotshwala kuholela nemiphumela engathandeki. Mhlawumbe hhayi kuphela wehlise ukusebenza yokwelapha, kodwa futhi ukuhlukumeza kwesibindi, isimiso sezinzwa esiyinhloko.

Izidakamizwa analogue "El-thyroxine"

Of analogs kwesakhiwo esikhundleni "Al-thyroxine" ingasetshenziswa "Eutiroks", "Bagotiroks". Umuthi iningi ngokuvamile akhethiwe "Eutiroks" esesikhundleni efanayo izimpawu, contraindications umthamo. Kusukela "El-thyroxine" uhluka kuphela lokuhlushwa izidakamizwa esebenzayo. Uma isiguli asifanele, "El-thyroxine" analogue esimisiwe uchwepheshe ikhumbula izici umzimba.

Izibuyekezo sokulungiselela "El-thyroxine"

Kusahlaziywa, leli phephandaba elibike ukuthi izidakamizwa uma kusetshenziselwa ngemithamo ongaphakeme ikhuthaza esivuthayo fat ngenxa ukusheshisa umzimba, ukucindezelwa ukudla ukwandisa nezindleko caloric. Nciphisa ukubonakala side effects noma ukuvimbela ukuthuthukiswa yabo usizo β-blocker. Izibuyekezo zibonisa ukuthi abantu abaningi hlanganisa imithi nge zindlela. Naphezu kweqiniso lokuthi "thyroxine" ngokuvamile kuyasiza ukunciphisa umzimba, ukuyisebenzisela kwesisindo is hhayi Kunconywa. Kubantu enempilo, imithi kungaba yingozi.

Ekwelapheni yizifo ezihlobene nokungabikho kahle yegilo umsebenzi, ngokuvamile umuthi ngempumelelo, njengoba kufakazelwa isibuyekezo. Ichaza amathuluzi kuholela ibhalansi evamile yama-hormone, ngakho iziguli zizizwe kangcono. Kukhona Izibuyekezo ezingezinhle ngenxa ngezinye izikhathi ukuthuthukisa imiphumela emibi. Nakuba izidakamizwa futhi unekhono kubangele inani elikhulu ukusabela ezingezinhle, kusekela yegilo, lapho umzimba usebenza kahle.

Ukusebenzisa "El-thyroxine" ngokuhamba kwesikhathi kungaba zisuswe kusukela isifo abanale nkinga noma ukunciphisa ububi besimo sokuguquka izimpawu ukuphila kwabo konke.