[Study] Antithyroid preparation

Methimazole (also known as Tapazole or Thiamazole or MMI) is an antithyroid drug,^[2] and part of the thioamide group.

[hide] v   t   e Thyroid therapy (H03) Thyroid hormones Levothyroxine#   Liothyronine   Liotrix   Tiratricol   Thyroid gland preparations Antithyroid preparations Thyroid peroxidase inhibitors (thioamide) Thiouracils: Propylthiouracil#   Methylthiouracil   Benzylthiouracil Sulfur-containing imidazole derivatives: Carbimazole   Methimazole Block conversion of T4 to T3 Propylthiouracil#   Ipodate Sodium-iodide symporter inhibitor Perchlorate (Potassium perchlorate)   Pertechnetate (Sodium pertechnetate) Other Diiodotyrosine   Dibromotyrosine #WHO-EM   ‡Withdrawn from market   Clinical trials:  †Phase III   §Never to phase III M: END anat/phys/devp/horm noco (d)/cong/tumr, sysi/epon proc, drug (A10/H1/H2/H3/H5)

source: http://en.wikipedia.org/wiki/Methimazole

[Study] Thyroid Hormone Drugs

triiodothyronine (T3) and thyroxine (T4)

Medical use

Both T₃ and T₄ are used to treat thyroid hormone deficiency (hypothyroidism). They are both absorbed well by the gut, so can be given orally. Levothyroxine is the pharmaceutical name (INN) of levothyroxine sodium (T₄), which is metabolised more slowly than T₃ and hence usually only needs once-daily administration. Natural desiccated thyroid hormonesare derived from pig thyroid glands, and are a "natural" hypothyroid treatment containing 20% T₃ and traces of T₂, T₁ and calcitonin. Also available are synthetic combinations of T₃/T₄ in different ratios (such as liotrix) and pure-T₃ medications (INN: liothyronine). Levothyroxine Sodium is usually the first course of treatment tried. Some patients feel they do better on desiccated thyroid hormones; however, this is based on anecdotal evidence and clinical trials have not shown any benefit over the biosynthetic forms.

Thyronamines have no medical usages yet, though their use has been proposed for controlled induction of hypothermia, which causes the brain to enter a protective cycle, useful in preventing damage during ischemic shock.

Synthetic thyroxine was first successfully produced by Charles Robert Harington and George Barger in 1926.

Formulations

Today most patients are treated with levothyroxine, or a similar synthetic thyroid hormone.However, natural thyroid hormone supplements from the dried thyroids of animals are still available.Natural thyroid hormones have become less popular, due to evidence that varying hormone concentrations in the thyroids of animals before they are slaughtered leads to inconsistent potency and stability. Levothyroxine contains T4 only and is therefore largely ineffective for patients unable to convert T4 to T3. These patients may choose to take natural thyroid hormone as it contains a mixture of T4 and T3, or alternatively supplement with a synthetic T3 treatment. In these cases, synthetic liothyronine is preferred due to the potential differences between drug lots of natural thyroid products. It would be counterintuitive to supplement with T4-only if the patient cannot convert T4 to T3. Some natural thyroid hormone brands are F.D.A. approved, but some are not. Thyroid hormones are generally well tolerated. Thyroid hormones are usually not dangerous for pregnant women or nursing mothers, but should be given under a doctor's supervision. In fact, if a woman who is hypothyroid is left untreated, her baby is at a higher risk for birth defects. When pregnant, a woman with a low functioning thyroid will also need to increase her dosage of thyroid hormone. One exception is that thyroid hormones may aggravate heart conditions, especially in older patients; therefore, doctors may start these patients on a lower dose & work up to avoid risk of heart attack.

source: http://en.wikipedia.org/wiki/Thyroxine

Levothroxine Education:

[NEWS] 東院確診抗藥肺癆追蹤逾百人

now.com 新聞 – 2013年9月16日星期一下午7:36

本台獲悉，東區醫院一名肺癆病人證實出現抗藥性，醫學界高度關注。由於病人先後住過3間醫院，當局要追蹤超過一百名接觸者，調查有沒有感染這種惡菌。

東區醫院今年5月接收了一名82歲男病人，經多重測試後，證實感染了抗藥性肺癆，院方嚴陣以待。

該名病人曾經入住另外兩間醫院，包括葛量洪醫院及東華東院，由於肺癆菌可經空氣傳播，當局擔心有更多人受感染，要追蹤跟進的人超過100名。

東區醫院證實，病人目前情況穩定。行政總監劉楚釗承認，肺癆病人入院時，難以即時知道病菌有否抗藥性。院方已將事件通報衞生防護中心跟進。

現時，港人感染肺癆個案每年逼近5000宗。港大感染及傳染病中心總監何栢良表示，肺癆患者痰液的含菌量愈高，傳人風險愈強。但他估計，今次病人病情不算嚴重，大規模傳播惡菌的風險不高。

[NEWS] 袁國勇：需控制抗萬古霉素腸道鏈球菌防惡化

香港電台 – 7小時前

因應病人感染帶有抗萬古霉素腸道鏈球菌個案增加，衞生防護中心為安老院職員舉辦講座，講解相關的感染控制措施。

港大微生物學系系主任袁國勇表示，現時驗出帶有抗萬古霉素腸道鏈球菌的病人不足1%，但假如不加以控制，情況可能會惡化。袁國勇又說，要預防感染抗萬古霉素腸道鏈球菌，必須做好「出入口管制」，要求長者或病人吃藥前以酒精搓手，以及在如廁前以酒精清潔廁板。他又提醒院舍職員要留意床欄、床簾及水樽等容易藏有病菌的地方。

瑪麗醫院感染控制主任鄭智聰表示，抗萬古霉素腸道鏈球菌在本港只是萌芽階段，醫院應加強早期監測，及早找出並隔離帶菌者，避免交叉感染，減少治療時間和資源。