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KarmenM -> RE: prekinitev dojenjazaradi zdravil (12.5.2006 14:18:59)
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Draga Nat30,
slučajno sem zajadrala semkaj in videla vaše sporočilo. Vsekakor se posvetujte z zdravnikom tierologom, odvisno od preiskav in terapije - ni nujno da bi morali z dojenjem nenadoma končati. Če imate možnost, kontaktirajte v LJ Kliničnem centru na Nuklearni kliniki dr. Edija Pirnata.
Ker sem pred nekaj dnevi za neko drugo mamico ravno iskala informacije glede dojenja in tega zdravila, vam jih kar takole posredujem... Če ne berete angleško, prosim sporočite, da vam jih prevedem...
ATHYRAZOL
Thyamazole can be found under generic name methimazole in dr. Hale's book (Medications and Mothers Milk, strani 537-538). It is the same.
Hale writes: "Lactation risk category: L3AAP: meternal Medication Usually Compatible with Breastfeeding Levels depend on maternal dose but appear too low to produce clinical effects. In one study of a patient receiving 2,5 mg methimazole every 12 hours, the milk/serum ratio was 1,16, and the dose perday was calculated at 16-39 microgram methimazole. This was equivalent to 7-16% of the maternal dose. In a study of 35 lactating women receiving 5-20 mg/day of methimazole, no changes in the infant thyroid function were noted in any infant, even dose at higher doses." He writes more on this, if you need I can copy it, Karmen but I understand you also have the book. What is important he writes in Pediatric concerns: "None reported in several studies but propylthiouracil may be a preferred choice in breastfeeding women." According to his other book, Clinical Therapy in Breastfeeding Patients (2002. edition): "(hyperthyroidism) treatment involves use of antithyroid medications, beta-blockers for treatment of thyroid storm (thyrotoxicosis). (...) Propranolol (beta-blocker) has been studied in breastfeeding women and in most cases produces no untoward effects on the infant but watch for hypotension and hypoglicaemia. (...) To suppress maternal thyroid function propylthiouracil is usually the drug of choice in breastfeeding mothers as its milk levels are the least. Numerous studies have been done and no change in thyroid function in any infant has been reported. PTU levels in milk are very loww. Recent studies of methimazole suggest it is a suitable alternative. In 5 studies of over 187 hyperthyroid breastfeeding women treated with methimazole with doses as high as 20 mg/day, no changes in thyroid function were noted in any infant. In most infants methimazole was undetectable in the plasma. While PTU is a preferred choice due to its suppression of peripheral conversion of T4 to T3, methimazole is undoubtedly safe as well. Monitoring for thyroid function and leucocytopenia in the breastfed neonate, while not mandatory, may be prudent." I hope these references can be useful for the mother and her doctor: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12841536&query_hl=1&itool=pubmed_docsum http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12109618&query_hl=1&itool=pubmed_docsum http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10931098&query_hl=1&itool=pubmed_docsum Če ste iz Ljubljane, kontaktirajte pediatrinjo dr. Andrejo Arnšek Domian, IBCLC v Ljubljanski porodnišnici ali MB pediatrinjo dr. Andrejo Tekauc Golob, IBCLC, na tel. 02/ 321-24-532. Nat30, želim vam sreče in zdravja!
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