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liothyronine sodium

When administered levothyroxine liothyronine sodium is absorbed almost exclusively in the upper small intestine. Absorbed 80% of the dose of the drug. Food intake reduces the absorption of levothyroxine. Maximum serum concentration is reached approximately 5-6 hours after ingestion. After absorption of more than 99% of the drug is bound to serum proteins (thyroxine-binding globulin, thyroxine binding prealbumin, and albumin). In various tissues occurs monodeyodirovanie levothyroxine about 80% to form triiodothyronine and inactive ingredients. Thyroid hormones are metabolized mainly in the liver, kidney, brain and muscles. A small amount of the drug undergoes deamination and decarboxylation as well as sulfuric acid and conjugated with glucuronic acid (in the liver).The metabolites are excreted in the urine and bile. The half-life of levothyroxine is 6-7 days. When thyrotoxicosis half-life is shortened to 3-4 days, and hypothyroidism is extended to 910 days. Liotironin . Absorption ingestion – 95% (4 hours). Relationship to plasma proteins – high. The half – 2.5 days.

Indications

  • hypothyroidism liothyronine sodium;
  • euthyroid goitre;
  • as replacement therapy and for the prevention of goiter recurrence after resection of the thyroid gland;
  • thyroid cancer (after surgery);
  • Graves’ disease: after reaching tireostatikami euthyroid state (a combination therapy).

Contraindications

  • Individual hypersensitivity to the drug;
  • untreated thyrotoxicosis;
  • acute myocardial infarction, angina III-IV functional class;
  • acute myocarditis;
  • untreated adrenal insufficiency.

Precautions
should be prescribed the drug for diseases of the cardiovascular system: ischemic heart disease (atherosclerosis, angina pectoris I-II functional class, history of myocardial infarction), heart failure, hypertension, tachycardia, tachyarrhythmia; diabetes, severe long-existing hypothyroidism, liothyronine sodium malabsorption syndrome (may require dose adjustment); elderly patients.

Use during pregnancy and lactation
During pregnancy and breast-feeding therapy with thyroid hormones, appointed about hypothyroidism, should be continued. During pregnancy, you want to increase the dose of the drug due to increased levels of thyroxine-binding globulin.
The use of the drug during pregnancy in combination with tireostatikami contraindicated, as may be necessary to increase the dose thyreostatics. Since tireostatiki unlike levothyroxine can cross the placenta, the fetus may develop hypothyroidism.
The amount of thyroid hormone secreted by breast milk during lactation (even during the treatment with high doses of the drug), is insufficient to cause any disorders in children. However, breast-feeding period, the drug should be taken with caution, strictly within the recommended doses under medical supervision.

Dosage and administration
The daily dose is determined individually, depending on indications. Hypothyroidism. Adults : Treatment starts with 1 tablet thyrotomy a day, then the dose may be increased to 1 tablet every 2-4 weeks until the maintenance daily dose is 2-5 tablets. Children : the selection of doses for long-term care into account body weight, height, and the child’s body surface. The average recommended maintenance dose is 2-2½ tablets a day thyrotomy. Euthyroid goiter . Adults : initial dose of 1-2 tablets per day, maintenance dose -3-6 tablets a day. Teenagers : the initial dose is 1-1½ tablets a day, maintenance dose – 2½-3½ tablets a day. Children : appoint ½-1 tablet per day. Preventing relapse after surgical treatment of goiter. Adults appoint 2-3 tablets a day. after surgery for cancer of the thyroid gland . The initial dose is 3 tablets a day, maintenance dose -. 6 tablets per day daily dose taken once chime, at least 30 minutes before breakfast without chewing and drinking plenty of fluids. The drug should be carried out regularly.The duration of treatment is determined by the form of the disease. Typically, in hypothyroidism and after about thyroidectomy thyroid cancer treatment liothyronine sodium is carried out over a lifetime. Duration of treatment with euthyroid goitre, as well as for the prevention of goiter recurrence after surgical treatment ranged from months or years to use throughout their lives.

Side effects
Common side effects are not observed When used properly, under the supervision of a physician.
There may be an allergic reaction, liothyronine sodium the progression of heart failure and angina.

cytomel t3

In an application with phenytoin, salicylates, dikumarol, clofibrate, furosemide in high doses (250 mg) increases the effects cytomel t3 as increases the content of unbound to proteins blood thyroid hormone plasma.
Enhances the effect of anticoagulants, which may require a reduction in their dose.
The use of tricyclic antidepressants cytomel t3 may lead to increased action of antidepressants.
Thyroid hormones may increase the need for insulin and oral hypoglycemic drugs. More frequent monitoring of blood glucose is recommended during the beginning of treatment and when changing its dosing regimen.
While the use of potassium-sparing diuretics Potassium iodide may increase potassium levels in the blood.
Reduces the effect of cardiac glycosides.
At the same time use of cholestyramine, colestipol and aluminum hydroxide reduces the plasma concentration of the drug due to inhibition of its absorption in the gut, so Tireokomb “is recommended to take 4-5 hours prior to receiving these drugs.
while the use of anabolic steroids, asparaginase, tamoxifen possible pharmacokinetic interaction at the level of binding with the protein.
Reception estrogensoderjath drug increases levels of thyroxine-binding globulin, which can increase demand for some patients. Somatropin while the use can speed up the closure of the epiphyseal growth zones.
Receiving phenobarbital, carbamazepine and rifampicin may increase levothyroxine clearance and demand increase  .

Cautions
When ischemic heart disease, heart failure or tachyarrhythmias require more frequent monitoring of thyroid hormone levels.
Particular caution should be exercised when administering the drug to elderly patients. The treatment they should be carried out with lower doses. In applying the drug in children with epilepsy, the likelihood of increasing the number of seizures.
Application  in patients with diabetes mellitus, diabetes insipidus or adrenal cortical insufficiency may lead to increased severity of these diseases. During this period, requires a careful selection of treatments for these diseases.
In hypothyroidism, caused the defeat of the pituitary gland, it is necessary to find out whether there is a failure of the adrenal cytomel t3 cortex simultaneously. In this case, the substitution therapy corticosteroids should be started before initiating treatment of hypothyroidism with thyroid hormone to prevent the development of acute adrenal insufficiency.
The drug has no effect on the professional activity associated with driving vehicles and management mechanisms.

 

cytomel dosage

When administered levothyroxine is absorbed almost exclusively in the upper small intestine (up to 80% of applied dose on an empty stomach). The maximum serum concentration achieved after cytomel dosage about 6 hours after ingestion. After absorption of more than 99% of the drug is bound to serum proteins (thyroxine-binding globulin, thyroxine binding prealbumin, and albumin). Therapeutic effect was observed within 3-5 days after the beginning of oral therapy. Levothyroxine is metabolized primarily in the liver, kidney, muscle, brain tissue.

The metabolites are excreted in the urine and bile. The half-life of levothyroxine is 6-7 days. After ingestion liothyronine is absorbed mainly in the small intestine in an amount of 78-95% of the dose. Maximum plasma concentration is achieved in about 2-3 days. Therapeutic effect stops after 7-9 days after the end of therapy. 90.7% liothyronine binds to thyroxine binding globulin in a small amount – from thyroxine binding prealbumin and albumin. During pregnancy or after treatment with estrogens is an increase in binding ability, in severe hypoproteinemia binding capacity may be reduced. Liothyronine is metabolized primarily in the liver, kidney, muscle, brain tissue. The half-life liothyronine -. 24 hours Absorbability inorganic iodine in the small intestine is almost 100%. Displayed iodine in urine.

Indications

 

  • hypothyroidism cytomel dosage;
  • Treatment of euthyroid goiter;
  • prevention of goiter recurrence after resection of the thyroid gland.Contraindications
  • Individual hypersensitivity to the drug;
  • hyperthyroidism;
  • acute myocardial infarction, angina III-1V functional class;
  • acute myocarditis;
  • untreated adrenal insufficiency;
  • dermatitis herpetiformis (Duhring’s disease).Precautions should be prescribed the drug for diseases of the cardiovascular system: ischemic heart disease (atherosclerosis, angina pectoris I-II functional class, history of myocardial infarction), heart failure, hypertension, tachycardia, tachyarrhythmia; diabetes mellitus, diabetes insipidus, a heavy long-existing hypothyroidism, malabsorption syndrome, elderly patients (may require dose adjustment).

    Use during pregnancy and lactation
    During pregnancy and breast-feeding therapy with thyroid hormones, appointed about hypothyroidism, should be continued. The amount of thyroid hormone secreted by breast milk during lactation (even during the treatment with high doses of the drug), is insufficient to cause any disturbances in the child. However, breast-feeding period, the drug should be taken with caution, strictly within the recommended doses under medical supervision.

    Dosage and administration
    The daily dose is selected individually by the attending physician based on clinical and laboratory data.
    Generally, treatment is initiated with  per day. Depending on the individual needs cytomel dosage of the initial dose can be gradually increased every 1-2 weeks prior to a maintenance dose of 1-2 tablets per day. In elderly patients with cardiovascular disease, patients with adrenocortical insufficiency and in patients with epilepsy, the period of selection of dose and adapting to it can be increased up to 4-6 weeks or more. All daily dose taken once in the morning at least 30 minutes before breakfast, not liquid, squeezed small amounts of liquid. The drug should be carried out regularly.
    The duration of the drug is determined by the attending physician. Patients are not recommended to independently modify or discontinue the treatment prescribed by your doctor.

    Side effects:
    When properly selected dose of medication side effects are not observed. There may be allergic reactions, progression of cardiac insufficiency and angina pectoris.
    Very rare hypersensitivity reactions in combination with the “iodine” rhinitis; yododerma, exfoliative dermatitis, angioedema; very rare – fever, iodine, iodine acne, swelling of the salivary glands. When adverse reactions reception  should be discontinued and to inform the treating physician.

    Overdose
    In case of overdose (especially with too rapid increase in dose at the beginning of treatment), symptoms of hyperthyroidism may occur: palpitations, irregular heartbeat, tremor of fingers, inner restlessness, insomnia, excessive sweating, weight loss, diarrhea. Depending on the severity of the symptoms your doctor may be recommended to decrease the daily dose, a break in treatment for a few days, the appointment of beta-blockers. After cytomel dosage the disappearance of side effects of treatment should be started cautiously with lower doses. In acute intoxication and overdose it is recommended to stop taking the drug and to conduct follow-up examination. Not recommended Tirostaticheskie funds. In applying the drug in very high doses it is shown holding a plasmapheresis.

t3 dosage

T3 dosage refers to a group tserebroaktivnyh funds shows nootropic anti-ischemic and anti-oxidant properties. The pharmacological effect of the drug due to the action of vzaimopotentsiiruyuschim thiotriazoline aipiratsetama. Piracetam – cyclic derivative of , nootropic agent; It acts directly on the brain, improving functions such as learning, memory, attention and consciousness, without causing sedation or psychostimulant effects. At the neuronal level, piracetam facilitates various types of synaptic transmission, providing preemptive effect on density and postsynaptic receptor activity. Piracetam hemorheological effects related to its effect on red blood cells, platelets and vascular wall. Thiotriazoline reacts with reactive oxygen species and lipid radicals due to expressed reduction properties of thiol group and prevents the occurrence of reactive oxygen species by the reactivation of antiradical enzymes. Superoxide dismutase, catalase and glutathione peroxidase
T3 dosage improves integrative and cognitive brain activity, facilitates the process of learning eliminates amnesia increases the performance of short-term and long-term memory.

The pharmacokinetics
has not been studied.

Indications for use
Chronic cerebral ischemia, the recovery period of ischemic stroke (including in patients with cognitive impairment nedementnoe), diabetic encephalopathy.

Contraindications for use

 

  • hypersensitivity to piracetam or Thiotriazoline, as well as other components of the drug;
  • Huntington’s chorea;
  • acute ischemic stroke (hemorrhagic stroke);
  • severe chronic renal failure (creatinine clearance less than 20 mL / min);
  • psychomotor agitation t3 dosage at the time of appointment of the drug;
  • childhood;
  • pregnancy and lactation;
  • Hereditary lactose intolerance, lactase deficiency;
  • deficit sucrase / isomaltase, fructose intolerance;
  • glucose-galactose malabsorption.Precautions for the use
    with caution the drug is prescribed to patients with chronic renal insufficiency (creatinine clearance 20-80 ml / min). Tiotsetam effect on platelet aggregation should therefore be used with caution in patients with impaired hemostasis in surgical interventions, heavy bleeding. Precautions should use the drug to the elderly with cardiovascular disease due to the fact that in this group of patients the most adverse reactions.

    The ability and features of medical use of the drug by pregnant women, women during the period of breastfeeding, children, adults with chronic diseases
    experience of use during pregnancy or lactation is not available, so the drug should not be given to this category of women. Experience of the drug for the treatment of children there, and the drug is contraindicated for the treatment of children under 18 years.

    Dosing and Administration
    Inside for 30 minutes. before eating.
    In chronic violations of cerebral circulation, and in the recovery period after an ischemic stroke 2 tablets 3 times a day for 25-30 days. The course of treatment can be extended up to 3-4 months.
    For the treatment of diabetic encephalopathy appoint on 2 tablets 3 times a day for 45 days.
    The last dose taken within 17 hours (to avoid sleep disturbance).

    Possible side effects when using the drug in the nervous system: motor disinhibition, irritability, drowsiness, depression, asthenia, headache, dizziness, tinnitus, insomnia, mental stimulation, impaired balance, ataxia, exacerbation of epilepsy, anxiety, hallucinations, confusion, on the part of the gastrointestinal tract: nausea, vomiting, diarrhea, abdominal pain t3 dosage (including gastralgia) and bloating, dry mouth;from the cardiovascular system: tachycardia, increased blood pressure, pain in the heart , adults, elderly patients may obostreniekoronarnoy failure, allergic reactions: hypersensitivity, anaphylactic reactions, including dermatitis, itching, hives and angioedema, fever, from respiratory: shortness of breath, asthma attacks, on the part of metabolism: increased body mass by hearing: vertigo.

     

    Overdose symptoms, relief measures in overdose symptoms: the occurrence or increased severity – dose-related side effects of the drug. Treatment: . Removal of the drug, induction of vomiting, gastric lavage, symptomatic therapy Interactions with other drugs Tiotsetam can not be simultaneously used with compounds having an acid value pH. Due to the presence of piracetam enhanced effect of antidepressants and antianginal drugs. When concomitant administration with thyroid hormones can be confusion, irritability and sleep disturbances. Piracetam does not inhibit cytochrome P450 isozymes.Metabolic interactions with other drugs are unlikely. Joint reception with alcohol did not affect the level of piracetam serum concentration; ethanol concentration in serum did not change when receiving 1.6 g piracetam.

     

    Cautions
    When long-term therapy in elderly patients is recommended regular monitoring of renal function, when necessary, a correction of the dose depending on creatinine clearance.

    Effects on ability to drive vehicles and management of machines and mechanisms
    in the period of treatment should refrain from driving motor vehicles and activities potentially hazardous activities t3 dosage that require high concentration and psychomotor speed reactions (driving, etc.).