title: [Parenteral replacement of 1-T4 in hypothyroid patients with esophageal stenosis and unconsciousness].
abstract: Hypothyroid patients are usually treated with in an oral administration of 1-T4. When oral administration is impossible because of esophageal stenosis or unconsciousness in such patients, parenteral replacement is required. We prepared a solution of 1-T4 50 micrograms/ml for intravenous administration in Tohoku University Hospital as follows: 5mg of 1-T4 (Nakarai Co.) was dissolved in 1ml of 0.1N NaOH and diluted with 0.9% NaCl and sterilized with membrane filter. Two patients with esophageal stenosis due to thyroid cancer and esophageal cancer and one in a coma due to adrenal crisis had replacement with intravenous 1-T4. Initial doses of 12.5 micrograms or 25 micrograms diluted with 100ml of 0.9% NaCl containing 1% albumin were given by drip infusion. Every week 12.5 micrograms or 25 micrograms of 1-T4 was increased. By replacement of low doses, 50 micrograms or 75 micrograms, serum T4 reached a normal level. No adverse action was observed during or after parenteral replacement. The preparation of 1-T4 was stable at least for one year and 11 months. Parenteral replacement of T4 is a useful and safe method for patients who are unable to take drugs orally.
authors.affiliation: Department of Health Control, Sendai General Hospital, East Japan Railway Company, Miyagi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: K
authors.initials: K
authors.lastname: Yoshida
authors.forename: K
authors.initials: K
authors.lastname: Yonezawa
authors.forename: M
authors.initials: M
authors.lastname: Mizugaki
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000150:complications*; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D013974:Thyroxine / Q000008:administration & dosage*; D014474:Unconsciousness / Q000150:complications*
chemical_list: D013974:Thyroxine