阿摩線上測驗
61 下列有關於 thioamides 用於治療甲狀腺功能亢進（hyperthyroidism）敘述，何者錯誤？
(A) Propylthiouracil（PTU）可用於孕婦的治療
(B) Methimazole 作用時間為服藥後 2-4 週
(C) Methimazole 不可以每日單次投藥（once-daily dosing）的方式給藥
(D) PTU 與 methimazole 療效相近（remission rate）
統計： A(26), B(55), C(334), D(90), E(0) #412600
詳解 (共 5 筆)
孕婦 | 用藥 | CI |
憂鬱 | ☄ TCA ☄ Fluoxetine(SSRI) |
|
DM | ☄ Human Insulin |
|
頭痛 | ☄ Acetaminophen |
|
偏頭痛 | ☄ Acetaminophen ☄ Codein ☄ Dimenhydrinate | ☄ Ergotamine |
高血壓 | ☄ Methyldopa ☄ Labetalol | ☄ RAAS藥: ACEI、ARB、Aliskiren |
甲亢 | ☄ PTU | ☄ I2 |
躁症 | ☄ Li ➔ CI: 授乳婦女 ☄ Haloperidol ☄ Chlorpromazine |
|
噁心嘔吐/ 動暈症 | ☄ Dicletin (Doxylamine + B6) |
|
栓塞 | ☄ Heparin ☄ Streptokinase | ☄ Warfarin ➔但可用於授乳婦女 |
UTI | ☄ Ampicillin ☄ Amocillin | ☄ Trimethoprim (TMP) ☄ Quinolones ☄ Sulfonamides |
披衣菌感染 | ☄ Amocillin ☄ Erythromycin | ☄ Tetracycline ☄ Doxycycline |
癲癇 | ☄ Monotherapy ☄ Phenobarbital | ☄ Phenytoin ☄ Carbamazepine ☄ Valproate |
PUD | ☄ Antacids ☄ Mg(OH)2, Al(OH)3 ☄ Ranitadine |
|
| 蛋白結合率 | 半衰期 | Onset | 效果 | 起始劑量 | 維持劑量 | 過胎盤 | 副作用 | 首選族群 | |
| PTU | 高(85%) | 短(75分) | 快 | 較弱 | 300mg QD/TID |
50-300mg | 有 | 肝毒性 | 孕婦 |
| MMI | 低(8%) | 長(4-6小時) | 短 | 較強 | 30mg QD/TID |
5-30mg | 有 | 顆粒性白血球低下 | 小孩 |
methimazole
Hyperthyroidism
Initial:
Mild hyperthyroidism: 5 mg orally every 8 hours.
Moderately severe hyperthyroidism: 10 mg orally every 8 hours (up to 40 mg per day).
Severe hyperthyroidism: 20 mg orally every 8 hours.
Maintenance:
5 to 15 mg orally daily.
Methimazole Pregnancy Warnings
Methimazole has been assigned to pregnancy category D by the FDA. Methimazole readily crosses the placental membranes and can induce goiter and cretinism in the developing fetus.
The risk is especially high during first trimester (during organogenesis).
The manufacturer recommends using the lowest dose possible if methimazole is used during pregnancy.
Propylthiouracil is typically the preferred agent in pregnancy as is crosses the placenta to a lesser degree.
