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How does the fluid intake affect the gastrointestinal absorbtion of levothyroxine.
Kročová, Radka ; Krátký, Jan (advisor) ; Hána, Václav (referee)
Thyroid diseases belong among the most common endocrinopathies, and, therefore, thyroid hormones are among the most commonly prescribed drugs in the Czech Republic, as well as in the world. Even though untreated thyropathies may cause several health complications for the patients, poorly administered treatment can also hurt the health of the individual. Several factors make the treatment difficult. A type of fluid used to ingest the drug belongs among such factors, and it represents the focus of this Master thesis. As is indicated by its title, the thesis focuses explicitly on the gastrointestinal absorption of levothyroxine after being ingested with water, black tea or cow's milk. The thesis was aimed at determining whether and to what extent, if any, the fluids may influence the gastrointestinal absorption of the drug. Based on this premise, research was conducted with six test subjects who underwent a relatively challenging absorption test with four blood samples taken over six hours. The data set (altogether 56 samples taken from all test subjects) had revealed that the gastrointestinal absorption of levothyroxine reached its maximum values when the drug was ingested with water. The other test fluids impair the bioavailability of L-thyroxine, and patients should wait to indulge in them at least...
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Weight and BMI in relation to the dose of levotyroxin of patients with hypothyreosis
Radiměřská, Veronika ; Jiskra, Jan (advisor) ; Ježková, Jana (referee)
The objective of this study was to define if there is a mutual influence between the daily dose of levothyroxine, positivity/negativity of thyroid antibody, BMI, waistline, hip measurement and other anthropometric parameters. It was also to analyze if the daily dose of levothyroxine is being influenced by degree of hypothyroidismimportance. Methodology: There were 44 patients examined having hypothyroidism and who have been cured with levothyroxine so that their thyroid function has been normal at the time. I have examined those patients' body height, weight, BMI, waistline and hipline. Under the supervision of the medicine doctor I used records available for each of patients regarding concentration of TSH, TPOAb and TgAb, which were defined with patients' blood by a method of immunoassay. Results: The average daily dose of levothyroxine in all patients sample has showed a positive correlation with BMI (Spearman rho coef. 0,429, P value=0,004) and with waistline of women (Spearman rho coef. 0,332, P value=0,028). The concentration of thyroidantibody did not show a statistical relevance regarding the dependence with the dose of levothyroxine, BMI or other anthropometric parameters.The highest average daily dose of levothyroxine was confirmed for examined patients after total thyroidectomy (median of...
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Drug interactions of drugs used in thyroid diseases
Teťáková, Veronika ; Malý, Josef (advisor) ; Marešová, Helena (referee)
Drug interactions of drugs used in thyroid diseases Author: Veronika Teťáková1 Tutor: PharmDr. Josef Malý, Ph.D.1 1 Department of Social and Clinical Pharmacy, Charles University, Faculty of Pharmacy in Hradec Králové Introduction and objectives: Drug interactions are considered to be a significant aspect of pharmacotherapy that can lead to the potentiation of toxicity and side effects of drugs. However, their identification and adequate management of the use of drug combinations hampers a number of obstacles. The aim of this thesis was to summary information about the drug interactions of drugs used in thyroid diseases (levothyroxine, propylthiouracil, thiamazole) and to formulate articles describing the management of interactions in a clinical practice including information for the dispensation of these drugs. To compare the information presented in each database and to determine the degree of conformity between these sources. Methodology: Based on the use of numerous information sources (Micromedex, UpToDate, SPC, Stockley's Drug Interactions) lists of drug interactions of drugs used in thyroid disaeses were established. Information about these interactions were completed by findings from other sources (PubMed®, scientific reports, Google Scholar). The information presented in each of these...
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Estimation of risks associated with the occurrence of synthetic thyroid
PECH, Michal
The aim of this work was to provide a comprehensive overview of published findings regarding thyroid, thyroid hormones, their concentrations, stability in the aquatic environment and effect on fish. To determine the consumption of synthetic thyroid hormones in the Czech Republic, the data on the distribution of the drugs, in which they are contained, is analyzed over a period of five years (2011 - 2015). This has provided information about the issued amount of active ingredients i.e. levothyroxine (T4) and liothyronine (T3) for each year. T4 consumption increased over five years, except for 2013, with the highest consumption in 2015 corresponding to 34.6 kg of T4. T3 consumption ranged only in tens of grams before prescribing drugs containing T3 in the Czech Republic was ceased in September 2013. Based on the distribution of synthetic thyroid hormones, an estimate of concentrations that could normally occur in surface water was performed (PECRIVER). Two variants of the calculation were performed. The first variant was based on consumption of synthetic thyroid hormones. The second variant was based on excretion of thyroid hormones (including natural ones) by humans. Each of these variants was counted with the F value, i.e. the rate of removal of the chemical during the WWTP wastewater treatment process, from two different sources. The first source was the study by Svanfelt et al. (2010) where the efficacy of thyroid hormone removal during the WWTP purification process was 66% for T4 (this value was not determined for T3). The second source was EPI Suite software, which calculated the theoretical efficacy of removal of T4 and T3 at WWTP (35.83% for T4 and 5.36% for T3). The resulting concentrations were relatively low in the first variant. The median of the estimated concentrations of thyroid hormones in surface water with the efficacy of removing thyroid hormones during the WWTP purification process, taken from the study by Svanfelt et al. (2010), ranged from 0.6 - 0.7 ng-l-1 for T4. Using the theoretical value of the elimination rate calculated using the EPI Suite program, the median ranged from 1.1 to 1.3 ng-l-1 for T4 and from 0.0007 to 0.0025 ng-l-1 for T3 before it ceased to be used in September 2013. In the second variant, the resulting concentrations were somewhat higher. Median of the environmental concentrations of thyroid hormone with the removal rate taken from the study by Svanfelt et al. (2010) was determined to 1.5 ng-l-1 for T4. With the EPI Suite removal efficacy, the median was determined to 2.9 ng-l-1 for T4 and 0.13 ng-l-1 for T3. Estimated concentrations of thyroid hormones in surface water may currently seem relatively low to have a significant effect on fish, since the lowest thyroid hormone concentration at which any effect was observed ranged in tens of ng-l-1. However, it should be borne in mind that thyroid hormones enter the surface water as a result of incomplete removal during waste water treatment and fish are exposed to these hormones over a long period of time, meaning that even seemingly low concentration may pose a potential risk to aquatic organisms including fish. The fate of these hormones in the environment is therefore to be judged by further studies and toxicological experiments.
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