๋ ๋ณดํฐ๋ก์
๋ ๋ณดํฐ๋ก์ (l-Thyroxine ๋๋ T4)์ ์ฒ์ฐ ๊ฐ์์ ํธ๋ฅด๋ชฌ์ธ ํฐ๋ก์ ์ ํฉ์ฑ ํํ์ ๋๋ค. ์์ํ์์ **๊ฐ์์ ๊ธฐ๋ฅ ์ ํ์ฆ** ์น๋ฃ๋ฅผ ์ํ ์ผ์ฐจ ์ ํ ์ฝ๋ฌผ์ ๋๋ค. > **์์ ๊ฒฝ๊ณ :** ๊ธฐ์กด ์ฌ์ฅ ์งํ์ด ์๋ ํ์๋ ๊ณผ๋ํ ์ฌ์ฅ ์๊ทน์ ๋ฐฉ์งํ๊ธฐ ์ํด ์ด๊ธฐ์ ๋ ๋ฎ์ ์ฉ๋์ด ํ์ํฉ๋๋ค. ๋ํ ์๊ฐ๋ฉด์ญ ๋ค๋ฐ์ฑ ๋ด๋ถ๋น์ ์ฆํ๊ตฐ ํ์์์ ์ ๋์จ๋ณ์ ๋ฐํ์ํฌ ์ ์์ต๋๋ค.
์์ฉ ๊ธฐ์ : Levothyroxine acts as a replacement for endogenous thyroxine. It enters cells and is converted to the more active T3 (triiodothyronine). T3 then **binds to specific intracellular thyroid hormone receptors** in the nucleus โ **alters gene expression** โ regulates metabolism, growth, and development.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Hypothyroidism ยท 0.02-0.04 mg/kg/day OR 0.5 mg/m2 body surface area daily ยท PO ยท sid or divided bid ยท Lifelong ยท Dose given with food. Monitor serum T4 levels pre-dosing and 4-8 hours after dosing.
- Hypothyroidism ยท 0.02-0.04 mg/kg/day OR 0.5 mg/m2 body surface area daily ยท PO ยท sid or divided bid ยท Lifelong ยท Dose given with food. Monitor serum T4 levels pre-dosing and 4-8 hours after dosing.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Uncorrected adrenal insufficiency (Addison's disease)
- Acute myocardial infarction (general precaution)
์ด์๋ฐ์
- Tachycardia
- Excitability
- Nervousness
- Excessive panting
- Unmasking of Addison's disease
์ฝ๋ฌผ ์ํธ์์ฉ
- Catecholamines ยท Actions of catecholamines are enhanced by thyroxine ยท moderate
- Sympathomimetics ยท Actions of sympathomimetics are enhanced by thyroxine ยท moderate
- Insulin ยท Altered insulin requirements; monitor carefully during initiation of therapy ยท moderate
- Oestrogens ยท May increase thyroid requirements by increasing thyroxine-binding globulin ยท moderate
- Ciclosporin ยท Therapeutic effect may be reduced by thyroid hormones ยท moderate
- Digoxin ยท Therapeutic effect may be reduced by thyroid hormones ยท moderate
- Digitoxin ยท Therapeutic effect may be reduced by thyroid hormones ยท moderate
- Ketamine ยท Tachycardia and hypertension may develop when given to patients receiving thyroid hormones ยท major
๋ชจ๋ํฐ๋ง
- Serum total T4 levels (pre-pill trough and 4-8 hours post-pill peak)
- Clinical response (resolution of lethargy, weight gain, dermatological signs)
- Signs of thyrotoxicosis (panting, tachycardia, hyperactivity)
- Blood glucose in diabetic patients
๊ณผ์ฉ๋
Clinical signs of overdosage (thyrotoxicosis) include **tachycardia**, **excitability**, **nervousness**, and **excessive panting**. Treatment involves withholding the medication until signs resolve, then restarting at a lower dose. Acute massive overdose may require gastrointestinal decontamination and supportive care (e.g., beta-blockers for severe tachycardia).
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.