Statements in which the resource exists as a subject.
PredicateObject
rdf:type
rdfs:label
Triostat (Injection)
dailymed-instance:dosage
Adults: Myxedema coma is usually precipitated in the hypothyroid patient of long standing by intercurrent illness or drugs such as sedatives and anesthetics and should be considered a medical emergency. Therapy should be directed at the correction of electrolyte disturbances, possible infection, or other intercurrent illness in addition to the administration of intravenous liothyronine (T). Simultaneous glucocorticosteroids are required. Triostat (liothyronine sodium injection) (T) is for intravenous administration only. It should not be given intramuscularly or subcutaneously. No controlled clinical studies have been done with Triostat. The following dosing guidelines have been derived from data analysis of myxedema coma/precoma case reports collected by SmithKline Beecham Pharmaceuticals since 1963 and from scientific literature since 1956. An initial intravenous Triostat dose ranging from 25 mcg to 50 mcg is recommended in the emergency treatment of myxedema coma/precoma in adults. In patients with known or suspected cardiovascular disease, an initial dose of 10 mcg to 20 mcg is suggested . However, both the initial dose and subsequent doses should be determined on the basis of continuous monitoring of the patient's clinical condition and response to Triostat therapy. Normally at least four hours should be allowed between doses to adequately assess therapeutic response and no more than 12 hours should elapse between doses to avoid fluctuations in hormone levels. Caution should be exercised in adjusting the dose due to the potential of large changes to precipitate adverse cardiovascular events. Review of the myxedema case reports indicates decreased mortality in patients receiving at least 65 mcg/day in the initial days of treatment. However, there is limited clinical experience at total daily doses above 100 mcg. See PRECAUTIONS���Drug Interactions for potential interactions between thyroid hormones and digitalis and vasopressors.<br/>Pediatric Use: There is limited experience with Triostat in the pediatric population. Safety and effectiveness in pediatric patients have not been established.<br/>Switching to Oral Therapy: Oral therapy should be resumed as soon as the clinical situation has been stabilized and the patient is able to take oral medication. When switching a patient to liothyronine sodium tablets from Triostat, discontinue Triostat, initiate oral therapy at a low dosage, and increase gradually according to the patient's response. If L-thyroxine rather than liothyronine sodium is used in initiating oral therapy, the physician should bear in mind that there is a delay of several days in the onset of L-thyroxine activity and that intravenous therapy should be discontinued gradually.
dailymed-instance:descripti...
Thyroid hormone drugs are natural or synthetic preparations containing tetraiodothyronine (T, levothyroxine) sodium or triiodothyronine (T, liothyronine) sodium or both. Tand Tare produced in the human thyroid gland by the iodination and coupling of the amino acid tyrosine. Tcontains four iodine atoms and is formed by the coupling of two molecules of diiodotyrosine (DIT). Tcontains three atoms of iodine and is formed by the coupling of one molecule of DIT with one molecule of monoiodotyrosine (MIT). Both hormones are stored in the thyroid colloid as thyroglobulin and released into the circulation. The major source of Thas been shown to be peripheral deiodination of T. Tis bound less firmly than Tin the serum, enters peripheral tissues more readily, and binds to specific nuclear receptor(s) to initiate hormonal, metabolic effects. Tis the prohormone which is deiodinated to Tfor hormone activity. Thyroid hormone preparations belong to two categories: (1) natural hormonal preparations derived from animal thyroid, and (2) synthetic preparations. Natural preparations include desiccated thyroid and thyroglobulin. Desiccated thyroid is derived from domesticated animals that are used for food by man (either beef or hog thyroid), and thyroglobulin is derived from thyroid glands of the hog. Triostat (liothyronine sodium injection) (T) contains liothyronine (L-triiodothyronine or L-T), a synthetic form of a natural thyroid hormone, as the sodium salt. The structural and empirical formulas and molecular weight of liothyronine sodium are given below. L-Tyrosine, 0-(4-hydroxy-3-iodophenyl)-3,5-diiodo-, monosodium salt In euthyroid patients, 25 mcg of liothyronine is equivalent to approximately 1 grain of desiccated thyroid or thyroglobulin and 0.1 mg of L-thyroxine. Each mL of Triostat in amber-glass vials contains, in sterile non-pyrogenic aqueous solution, liothyronine sodium equivalent to 10 mcg of liothyronine; alcohol, 6.8% by volume; anhydrous citric acid, 0.175 mg; ammonia, 2.19 mg, as ammonium hydroxide.
dailymed-instance:clinicalP...
Thyroid hormones enhance oxygen consumption by most tissues of the body and increase the basal metabolic rate and the metabolism of carbohydrates, lipids and proteins. In vitro studies indicate that Tincreases aerobic mitochondrial function, thereby increasing the rates of synthesis and utilization of myocardial high-energy phosphates. This, in turn, stimulates myosin ATPase and reduces tissue lactic acidosis. Thus, thyroid hormones exert a profound influence on virtually every organ system in the body and are of particular importance in the development of the central nervous system. While the source of levothyroxine (T) and some triiodothyronine (T) is via secretion from the thyroid gland, it is now well-established that approximately 80% of circulating Tarises predominantly by way of the extrathyroidal conversion of T. The membrane-bound enzyme responsible for this reaction is iodothyronine 5'-deiodinase. Activity of the enzyme is greatest in the liver and kidney. A second pathway of Tto Tconversion occurs via a PTU-insensitive 5'-deiodinase located primarily in the pituitary and central nervous system. The prohormone Tmust be converted to Tin the body before it can exert biological effects. During periods of illness or stress, this conversion is often inhibited and can be diverted to the inactive reverse T(rT) moiety. Therefore, correction of the hypothyroid condition in patients with myxedema coma is facilitated by the parenteral administration of triiodothyronine (T). Tis bound much less firmly to serum binding proteins and therefore penetrates into the cells much more rapidly than T. Also, the binding of Tto a nuclear thyroid hormone receptor seems to initiate most of the effects of thyroid hormone in tissues. Although most thyroid hormone analogs, both natural and synthetic, will bind to this protein, the affinity of Tfor this receptor is roughly 10-fold higher than that of T. Thus, Tis the biologically active thyroid hormone.<br/>Pharmacodynamics: The clinical features of myxedema coma include depression of the cardiovascular, respiratory, gastrointestinal and central nervous systems, impaired diuresis, and hypothermia. Administration of thyroid hormones reverses or attenuates these conditions. Thyroid hormones increase heart rate, ventricular contractility and cardiac output, as well as decrease total systemic vascular resistance. They also increase the rate and depth of respiration, motilityof the gastrointestinal tract, rapidity of cerebration, and vasodilatation. Thyroid hormones correcthypothermia by markedly increasing the basal metabolic rate, as well as the number and activity of mitochondria in almost all cells of the body.<br/>Pharmacokinetics: Since liothyronine sodium (T) is not firmly bound to serum protein, it is readily available to body tissues. Liothyronine sodium has a rapid cutoff of activity which permits quick dosage adjustment and facilitates control of the effects of overdosage, should they occur. The higher affinity of levothyroxine (T) as compared to triiodothyronine (T) for both thyroid-binding globulin and thyroid-binding prealbumin partially explains the higher serum levels and longer half-life of the former hormone. Both protein-bound hormones exist in reverse equilibrium with minute amounts of free hormone, the latter accounting for the metabolic activity. Tis deiodinated to T. A single dose of liothyronine sodium administered intravenously produces a detectable metabolic response in as little as two to four hours and a maximum therapeutic response within two days. However, no pharmacokinetic studies have been performed with intravenous liothyronine (T) in myxedema coma or precoma patients.
dailymed-instance:activeIng...
dailymed-instance:supply
In packages of six 1 mL vials at a concentration of 10 mcg/mL.NDC 60793-721-06 Store between 2��and 8��C (36��and 46��F).
dailymed-instance:boxedWarn...
Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
dailymed-instance:activeMoi...
dailymed-instance:inactiveI...
dailymed-instance:overdosag...
Signs and Symptoms: Headache, irritability, nervousness, tremor, sweating, increased bowel motility and menstrual irregularities. Angina pectoris, arrhythmia, tachycardia, acute myocardial infarction or congestive heart failure may be induced or aggravated. Shock may also develop if there is untreated pituitary or adrenocortical failure. Massive overdosage may result in symptoms resembling thyroid storm.<br/>Treatment of Overdosage: Dosage should be reduced or therapy temporarily discontinued if signs and symptoms of overdosage appear. Treatment may be reinstituted at a lower dosage. In normal individuals, normal hypothalamic-pituitary-thyroid axis function is restored in six to eight weeks after cessation of therapy following thyroid suppression. Treatment is symptomatic and supportive. Oxygen may be administered and ventilation maintained. Cardiac glycosides may be indicated if congestive heart failure develops. Beta-adrenergic antagonists have been used advantageously in the treatment of increased sympathetic activity. Measures to control fever, hypoglycemia or fluid loss should be instituted if needed.
dailymed-instance:genericMe...
liothyronine sodium
dailymed-instance:fullName
Triostat (Injection)
dailymed-instance:adverseRe...
The most frequently reported adverse events were arrhythmia (6% of patients) and tachycardia (3%). Cardiopulmonary arrest, hypotension and myocardial infarction occurred in approximately 2% of patients. The following events occurred in approximately 1% or fewer of patients: angina, congestive heart failure, fever, hypertension, phlebitis and twitching. In rare instances, allergic skin reactions have been reported with liothyronine sodium tablets.
dailymed-instance:indicatio...
Triostat (liothyronine sodium injection) (T) is indicated in the treatment of myxedema coma/precoma. Triostat can be used in patients allergic to desiccated thyroid or thyroid extract derived from pork or beef.
dailymed-instance:represent...
dailymed-instance:routeOfAd...
dailymed-instance:name
Triostat