| Pharmacological treatment of hyperthyroidism during lactation: review of the literature and novel data. | |
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MedLine Citation:
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PMID: 21037541 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Antithyroid drugs (ATD) are used as a first line treatment in thyrotoxicosis. Propylthiouracil (PTU), carbimazole (CMZ) and methimazole (MMI) are available. During absorption CMZ is bioactivated to MMI. Initially, mothers were not allowed to breastfeed during treatment with ATD. Newer studies minimized the risk for mother and infant. PTU should be preferred over MMI due to its lower milk concentration. Recent studies have shown severe hepatic dysfunction for both ATD, but especially for PTU, in hyperthyroid patients. Most of those cases were idiosyncratic, not-dose related and presented a latent period of occurrence. No biomarkers could predict hepatic damage. The American Thyroid Association (ATA) has recommended that PTU should not be prescribed as the first line agent in children and adolescents. Its use might be accepted in the first trimester of pregnancy for severe thyrotoxicosis or for patients with previous MMI adverse reactions. Considering the potential harmful effects of PTU, MMI should be used instead during lactation. |
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Authors:
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Spiros Karras; Themistoklis Tzotzas; Themistoklis Kaltsas; Gerasimos E Krassas |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Pediatric endocrinology reviews : PER Volume: 8 ISSN: 1565-4753 ISO Abbreviation: Pediatr Endocrinol Rev Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-11-01 Completed Date: 2010-12-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101202124 Medline TA: Pediatr Endocrinol Rev Country: Israel |
Other Details:
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Languages: eng Pagination: 25-33 Citation Subset: IM |
Affiliation:
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Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece. krassas@the.forthnet.gr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antithyroid Agents / adverse effects, therapeutic use* Breast Feeding* Carbimazole / adverse effects, therapeutic use Child Development / drug effects, physiology Female Humans Hyperthyroidism / drug therapy*, metabolism* Infant Lactation Methimazole / adverse effects, therapeutic use Milk, Human / chemistry Mothers Propylthiouracil / adverse effects, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Antithyroid Agents; 22232-54-8/Carbimazole; 51-52-5/Propylthiouracil; 60-56-0/Methimazole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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