{"id":4462,"count":2,"description":"Hypertyre\u00f3za (zv\u00fd\u0161en\u00e1 funkce \u0161t\u00edtn\u00e9 \u017el\u00e1zy) nej\u010dast\u011bji zp\u016fsoben\u00e1 Gravesovou chorobou (autoimunitn\u00ed protil\u00e1tky proti TSH receptoru), toxickou mnohouzlovou strumou nebo solit\u00e1rn\u00edm toxick\u00fdm adenomem. Mezi p\u0159\u00edznaky pat\u0159\u00ed \u00fabytek hmotnosti p\u0159i norm\u00e1ln\u00ed\/zv\u00fd\u0161en\u00e9 chuti k j\u00eddlu, palpitace, t\u0159es, nesn\u00e1\u0161enlivost tepla, \u00fazkost, \u010dast\u00e1 stolice a (u Gravesovy choroby) o\u010dn\u00ed p\u0159\u00edznaky (exoftalmus, zpo\u017ed\u011bn\u00ed v\u00ed\u010dka, oftalmopatie). Katalog l\u00e9\u010dby hypertyre\u00f3zy MedsBase obsahuje tyreostatika ze skupiny thionamid\u016f, kter\u00e1 blokuj\u00ed tyreoid\u00e1ln\u00ed peroxid\u00e1zu a sni\u017euj\u00ed synt\u00e9zu hormon\u016f.\n\n<strong>Skladem.<\/strong> Methimazol (modern\u00ed preferovan\u00fd thionamid \u2014 jednou denn\u011b, m\u00e9n\u011b hepatotoxick\u00fd ne\u017e propylthiouracil krom\u011b prvn\u00edho trimestru t\u011bhotenstv\u00ed a tyreotoxick\u00e9 krize) je skladem jako <a href=\"https:\/\/medsbase.com\/cs\/methimez\/\">Methimez<\/a>. Karbimazol (prodrug methimazolu, \u0161iroce pou\u017e\u00edvan\u00fd v UK\/Evrop\u011b\/Indii\/Asii) jako <a href=\"https:\/\/medsbase.com\/cs\/neomercazole\/\">Neomercazole<\/a>.\n\n<strong>Jak pou\u017e\u00edvat.<\/strong> Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka p\u0159i st\u0159edn\u011b z\u00e1va\u017en\u00e9 Gravesov\u011b chorob\u011b: methimazol 15\u201330 mg denn\u011b nebo karbimazol 20\u201340 mg denn\u011b, s \u00fapravou podle hodnot TSH a voln\u00e9ho T4 m\u011b\u0159en\u00fdch ka\u017ed\u00fdch 4\u20136 t\u00fddn\u016f. V\u011bt\u0161ina pacient\u016f dos\u00e1hne euthyroidn\u00edho stavu b\u011bhem 6\u201312 t\u00fddn\u016f. Dlouhodob\u00e9 mo\u017enosti l\u00e9\u010dby: pokra\u010dov\u00e1n\u00ed v u\u017e\u00edv\u00e1n\u00ed tyreostatik po dobu 12\u201318 m\u011bs\u00edc\u016f (40% remise po vysazen\u00ed u Gravesovy choroby), radioj\u00f3dov\u00e1 ablace (definitivn\u00ed \u0159e\u0161en\u00ed, ale zp\u016fsobuje trvalou hypotyre\u00f3zu) nebo chirurgick\u00e1 tyreoidektomie. Beta-blok\u00e1tory (propranolol \u2014 viz <a href=\"https:\/\/medsbase.com\/cs\/heart-blood-pressure\/\">Srdce a krevn\u00ed tlak<\/a>) pro symptomatickou kontrolu bu\u0161en\u00ed srdce, t\u0159esu a \u00fazkosti b\u011bhem \u010dek\u00e1n\u00ed na \u00fa\u010dinek tyreostatik.\n\n<strong>D\u016fle\u017eit\u00e9.<\/strong> <strong>Povinn\u00e9 z\u00e1kladn\u00ed vy\u0161et\u0159en\u00ed FBC a jatern\u00edch test\u016f p\u0159ed l\u00e9\u010dbou.<\/strong> Tyreostatika zp\u016fsobuj\u00ed agranulocyt\u00f3zu u 0,1\u20130,5 % pacient\u016f (obvykle do 90 dn\u016f, vy\u0161\u0161\u00ed riziko p\u0159i vy\u0161\u0161\u00ed d\u00e1vce) \u2014 n\u00e1hl\u00e1 hore\u010dka, bolest v krku, afty vy\u017eaduj\u00ed okam\u017eit\u00e9 FBC a ukon\u010den\u00ed l\u00e9\u010dby, pokud je p\u0159\u00edtomna neutropenie. Hepatotoxicita \u2014 propylthiouracil v\u00edce ne\u017e methimazol; monitorov\u00e1n\u00ed jatern\u00edch test\u016f b\u011bhem po\u010d\u00e1te\u010dn\u00ed l\u00e9\u010dby. T\u011bhotenstv\u00ed: propylthiouracil preferov\u00e1n v prvn\u00edm trimestru (m\u00e9n\u011b teratogenn\u00ed \u2014 methimazol m\u016f\u017ee zp\u016fsobit apl\u00e1zii k\u016f\u017ee a choan\u00e1ln\u00ed atr\u00e9zii), pot\u00e9 p\u0159echod na methimazol ve druh\u00e9m trimestru. Subakutn\u00ed tyreoiditida se projevuje hypertyre\u00f3zou, ale NEREAGUJE na tyreostatika (vhodn\u00e9 jsou NSAID a beta-blok\u00e1tory; diferenci\u00e1ln\u00ed diagnostice pom\u016f\u017ee scan \u0161t\u00edtn\u00e9 \u017el\u00e1zy). V\u0161echny produkty MedsBase jsou odes\u00edl\u00e1ny z <strong>WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong> a jsou kryty na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>.","link":"https:\/\/medsbase.com\/cs\/overactive-thyroid-treatment\/","name":"L\u00e9\u010dba hyperaktivn\u00ed \u0161t\u00edtn\u00e9 \u017el\u00e1zy","slug":"overactive-thyroid-treatment","taxonomy":"product_cat","parent":3223,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/4462","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3223"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=4462"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}