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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
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Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
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Abnormal thyroid function tests in children on ethionamide treatment.

S Thee1, E W Zöllner, M Willemse

  • 1Department of Paediatric Pneumonology and Immunology, Charité, Universitätsmedizin Berlin, Berlin, Germany. steffi.thee@googlemail.com

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|September 28, 2011
PubMed
Summary
This summary is machine-generated.

Ethionamide (ETH) treatment frequently causes thyroid dysfunction in children. Over half of patients showed abnormal thyroid function tests, primarily indicating hypothyroidism or euthyroid sick syndrome.

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Area of Science:

  • Pediatric Endocrinology
  • Infectious Diseases
  • Pharmacology

Background:

  • Ethionamide (ETH) is a crucial second-line anti-tuberculosis drug.
  • Thyroid dysfunction, specifically hypothyroidism, is a known potential side effect of ETH treatment.
  • Monitoring thyroid function is important in children undergoing anti-tuberculosis therapy.

Purpose of the Study:

  • To assess the frequency and patterns of thyroid function test (TFT) abnormalities in children treated with ethionamide.
  • To identify risk factors associated with these TFT abnormalities.

Main Methods:

  • Retrospective analysis of clinical data from 137 children receiving anti-tuberculosis treatment including ETH.
  • Assessment of serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels.
  • Categorization of abnormal TFT results.

Main Results:

  • Thyroid function test abnormalities were observed in 79 (58%) of the children.
  • Common abnormalities included elevated TSH with suppressed fT4 (30 children), isolated elevated TSH (20 children), and isolated low fT4 (28 children).
  • Higher risk for biochemical hypothyroidism was noted in children on regimens including para-aminosalicylic acid and in those with human immunodeficiency virus infection.

Conclusions:

  • Thyroid function test abnormalities are common in children treated with ethionamide.
  • These abnormalities are predominantly due to primary hypothyroidism or euthyroid sick syndrome.
  • Consideration of concomitant medications and HIV status is important when monitoring thyroid function in these patients.