甲状腺素和治疗甲状腺功能减退:七个几十年的经验。

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马特奥RCI,亨尼西的合资企业

甲状腺素和治疗甲状腺功能减退:七个几十年的经验。

内分泌。2019年10月,66 (1):- 17。doi: 10.1007 / s12020 - 019 - 02006 - 8。Epub 2019年7月18日。

PubMed ID

31321670 (在PubMed

]

文摘

甲状腺功能减退是最常见的内分泌疾病之一,影响着全球10%的人口。有丰富的文化历史环境的治疗和干预约会早在2年。中国的白痴对待羊甲状腺在公元6世纪。1890年,移植动物甲状腺组织导致提示myxedematous病人的临床反应,并在1891年注射羊甲状腺被报道。一年后,新鲜羊的口服甲状腺被指出是有效的。在几年之内,用药的危险与提取识别和定量指导表明低剂量开始,逐渐增加的要求基于症状。口服摄入提取成为普遍的,到1914年甲状腺素结晶。1927年,甲状腺素合成酸,限制口服吸收。最后介绍了甲状腺素钠盐在1949年。这些合成制剂被用于临床使用。 Prior to 1970, extracts and combination therapy with synthetic LT4 and LT3 were standard replacement until the peripheral deiodinase-mediated T4 to T3 conversion documented the endogenous generation of T3 from LT4 in athyreotic subjects. This resulted in advocacy for patients previously treated with combinations and desiccated thyroid be transitioned to L-thyroxine monotherapy. The determination of the optimal dose has evolved such that now a general recommendation for replacement dosage of LT4 is 1.6-1.7 mcg/kg/day. Thyroid hormone extracts were established prior to the FDA's establishment in 1906, and when the Food, Drug, and Cosmetic act of 1938 enhanced the FDA's regulatory authority. In 1997, FDA declared LT4 products to be new drugs subject to regulation and quickly a pharmacokinetic process to determine interchangeability among approved LT4 products ensued. Differences in bioavailability of 12.5% or more may be considered therapeutically equivalent and therefore such products interchangeable. To assure refill to refill consistency, all levothyroxine sodium products now meet a 95-105% potency specification throughout their labeled shelf-lives. Seventy years after Kendall's great achievement in isolating thyroxine, we have thyroxine products with precise amounts of synthetic hormone that meet demanding regulations to assure high product quality, predictable bioavailability given its narrow therapeutic range, and now are left with potential variance in the therapeutic efficacy among different preparations.

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药物

甲状腺、猪