Potassium iodide - instructions for use, dose, side effects, contraindications

Antihyperthyroid (suppressing the release of thyroid hormones into the systemic circulation by reducing vascularization, thickening of the glandular tissue, reducing the size of cells,reakkumulyatsii colloid in the follicles and increase the proportion of bound iodine; these processes can facilitate the removal of the thyroid gland when used in the preoperative period).

Remedy thyroid ionizing radiation (at reception before and during exposure to radioactive iodine isotopes in medical interventions or radiation accidents blocks the uptake of radioactive isotopes thyroid iodine, when taking during irradiation protective effect of ~ 97% for 12 hours and 24 hours prior to impact - 90% and 70% respectively after 1 hour and 3 hours after the irradiation - 85% and 50% respectively, when taking more than 6 hours after exposure - protective effect is negligible).

Pharmacokinetics:

Absorption from the gastrointestinal tract is fast and complete. The concentration in the plasma is 0.1-0.5 μg / dL. Intensively absorbed by the thyroid gland, which is oxidized to iodine. Provides iodination of tyrosine in the thyroid gland to produce mono- and diiodotyrosine, thyroxine and triiodothyronine. It also accumulates in salivary and lactating mammary glands, stomach tissues (the content in saliva, milk and gastric juice exceeds the plasma level by 30 times).It is excreted by the kidneys, partly by the bronchial, salivary and lacrimal glands.

Indications:

- Prevention of iodine-deficiency diseases (endemic goiter) in areas with iodine deficiency, including in children, adolescents, pregnant and lactating women, preventing recurrence of goiter after resection of the thyroid gland;

- treatment of goiter and other iodine-deficient diseases in children (including newborns), adolescents and adults;

- hyperthyroidism, preparation for resection of the thyroid gland, thyrotoxic crisis;

- difficult sputum discharge (inflammatory diseases of the upper respiratory tract, bronchial asthma, actinomycosis of the lungs);

- prevention of thyroid absorption of radioactive iodine and protection from radiation;

- syphilis (resorption of infiltrates in the Tertiary period) - ancillary treatment;

- in ophthalmology: cataract, corneal and vitreous opacities, bleeding in the eye, fungal lesions of the conjunctiva and cornea;

- in dentistry: inflammatory diseases of the salivary glands, xerostomia.

ICD-10

IV.E00-E07.E01.0 Diffusive (endemic) goiter associated with iodine deficiency

IV.E00-E07.E01.1 Multinodular (endemic) goiter associated with iodine deficiency

Contraindications:

- hypersensitivity (including for topical application);

- hyperthyroidism, including diffuse and nodal toxic goiter (for use in all indications, except for antihyperthyroid remedy: prolonged use of iodine may lead to hyperplasia of the thyroid gland, development of thyroid adenoma, goiter or hypothyroidism);

- toxic adenoma and other benign thyroid tumors;

- pregnancy (with the exception of the threat of radioactive iodine, prescribe together with potassium perchlorate);

- lactation.

Carefully:No data.

Pregnancy and lactation:

Penetrates through the placenta. Use in pregnancy can lead to a disruption of the thyroid gland and / or goiter in a newborn and is possible only at recommended doses (when iodine intake from food is less than 150-300 μg per day). Penetrates into breast milk. The use of lactation (in doses of more than 1 mg per day) can cause skin rashes and suppression of thyroid function in a child.

The category of FDA recommendations is not defined.

Dosing and Administration:

Protection of the thyroid gland from ionizing radiation (before and after administration or inhalation of radioactive isotopes of iodine or in technogenic catastrophes with sources of radioactive isotopes):

- Inside (in the form of tablets, solution for ingestion or syrup) 130 mg once a day - until the risk of radioactive isotopes of iodine in the body is eliminated;

- Inside 100-150 mg for 24 hours before irradiation, then once in 3 days, the interval is gradually increased to 10 days throughout the period of exposure.

Treatment of goiter - 300-500 mcg per day.

Prevention of goiter with iodine deficiency is 100-200 μg per day.

Prevention of relapse after therapeutic treatment of endemic goiter - 100-200 μg per day.

The duration of treatment is determined by the doctor; prophylactically, an adult is usually prescribed for several months, years or a lifetime; children and adolescents - usually within 6-12 months.

Endemic goiter in middle-aged and older people - potassium iodide (300 μg per day) is comparable in effectiveness and safety with levothyroxine (1.5 μg / kg per day).

Prevention of recurrence of euthyroid endemic goiter after surgical resection - levothyroxine (75 μg) + potassium iodide (150 μg) to a greater extent reduce the size of the thyroid gland than monotherapy with levothyroxine or potassium iodide (200 μg).

Skin and lymphatic sporotrichosis:

- Inside (in the form of tablets, solution for ingestion or syrup) 600 mg 3 times a day; the dose is gradually increased with an increment of 60 mg until the maximum tolerated dose is reached.

Involution of the thyroid gland in the preoperative period (in combination with antithyroid agents before thyroidectomy):

- inside (in the form of a solution for ingestion with a concentration of 1 g / ml) 5 drops (~ 250 mg) 3 times a day for 10 days before surgery (usually in combination with antithyroid drugs);

- Inside (as a syrup) 4 ml (~ 260 mg) 3 times a day for 10 days before surgery (usually in combination with antithyroid drugs);

- inside 2 tablets (~ 260 mg), dissolved in 1 glass of water, 3 times a day for 10 days before surgery (usually in combination with antithyroid drugs).

Cataract, opacity of the cornea and vitreous, bleeding in the eye, fungal lesions of the conjunctiva, cornea and eyelid:

- in the conjunctival sac 2 drops 3-4 times a day for 10-15 days.

The effectiveness of potassium iodide as an expectorant is low.

Side effects:

On the part of organs GIT: nausea, vomiting, diarrhea, gastralgia, diarrhea.

From the nervous system and sense organs: anxiety, headache.

Allergic reactions: angioedema, hemorrhages on the skin and mucous membranes, swelling of the salivary glands, urticaria.

Other: changes in thyroid function (hyperthyroidism, hypothyroidism), hyperkalemia, parotitis, iodine toxicity (confusion, irregular heartbeat, numbness, tingling, pain or weakness in the hands and feet, unusual lethargy, weakness or heaviness in the legs); iodism (with prolonged use, especially in high doses): burning in the mouth or throat, metallic taste in the mouth, increased salivation, tenderness of the teeth and gums, redness of the conjunctiva, edema of the eyelids, rhinitis, fever, arthralgia, acne, dermatitis (exfoliative and other ), eosinophilia.

Overdose:

Symptoms of acute overdose: staining the mucous membrane of the oral cavity in brown, rhinitis, bronchitis, gastroenteritis, edema of the vocal cords, bleeding from the urinary tract, anuria, collapse (up to the lethal outcome).

Treatment of acute overdose: gastric lavage with a solution of starch (before the disappearance of the blue color of the solution) and 1% solution of sodium thiosulfate, taking cereal from flour, corn, potato, rice or oat thick broth, symptomatic and supporttherapy.

Interaction:

Antithyroid drugs - Combination can increase the hypothyroid and zobogenic effects of potassium iodide; It is necessary to determine the function of the thyroid gland before and periodically during therapy to detect changes in the response of the pituitary-thyroid system; because the potassium iodide can reduce the effect of thioamides in thyrotoxic crisis, it should be prescribed 1 hour before taking thioamides.

Incorporation of iodine into the thyroid gland Suppressed potassium perchlorate (at concentrations in the blood of more than 5 mg / ml) and stimulated thyroid-stimulating hormone.

Diuretics potassium-sparing - possible development of hyperglycemia and arrhythmia or cardiac arrest with parallel application; it is necessary to monitor the concentration of potassium in the blood plasma.

Captopril, enalapril, lisinopril - it is possible to develop hyperkalemia in parallel application; it is necessary to monitor the concentration of potassium in the blood plasma; however, standarddoses of potassium iodide in protection from radiation damage (130 mg) contain a small amount of potassium and do not cause problems when combined with ACE inhibitors.

Sodium iodide¹³¹I (in therapeutic doses), sodium iodide ¹²³I - potassium iodide can reduce capture ¹³¹I and ¹²³I with the thyroid gland.

Lithium preparations - it is possible to intensify the hypothyroid and zobogenous effects of potassium iodide in parallel application; it is necessary to determine the function of the thyroid gland before and periodically during therapy to detect changes in the response of the pituitary-thyroid system.

Special instructions:

General information.

The content of potassium is 6 meq (234 mg) / 1 g of potassium iodide.

To minimize irritation of the gastrointestinal tract, it is possible to take the drug after a meal or before bedtime, together with a meal or by taking the medicine with milk.

For the prevention of mucous membrane damage gastrointestinal tract concentrated solutions of potassium salts, it is recommended to add a full glass (240 ml) of water, fruit juice, milk or broth to the oral solution, the tablets are dissolved in ½ cup (120 ml) of water or milk; to prepare a solution of low concentration, a 130 mg tablet can be dissolved in 240 ml of water - a solution with a concentration of 0.54 mg / ml will be obtained (30 ml of the solution contain 16 mg).

Long-term use of an iodine dose of more than 1 mg per day causes a decrease in the absorption of iodine by the thyroid gland and the synthesis of thyroid hormones, which subsequently manifests itself in the form of hypothyroidism, goitre, mumps, iodism, and acneiform skin lesions (especially in post-pubertal age).

In emergency situations, if you can not count the necessary dose, you can take 130 mg with all patients, except for newborns.

Monitoring: the concentration of potassium in blood plasma (periodically during therapy for impaired renal function).

Distinctive features:

- potassium iodide can cause an increase or engorgement of the salivary glands, burning in the mouth or throat, metallic taste, tooth and gum sore and unusual enhancement of salivation.

Application in children: potassium iodide can cause skin rashes and suppression of the thyroid gland in young children. Studies of tolerability when used as a systemic antifungal agent have not been conducted.

Studies on the tolerability of potassium iodide in elderly patients have not been carried out, however, the factors limiting its use in this category of patients have not been determined.

Features of combining with diagnostic studies.

Thyroid function studies, radionuclide studies of the thyroid gland, tests of thyroid accumulation - potassium iodide can reduce the accumulation ¹³¹I, ¹²³I and sodium pertechnetate ^99mTc in the thyroid gland.

It is not recommended to use potassium iodide in the form of slow dissolution tablets, since this dosage form can cause small bowel damage with the development of its obstruction, bleeding, perforation and possibly death.

Instructions

Potassium iodide (Kalii iodidum)