disodium;(2S)-2-amino-3-[4-(3,5-diiodo-4-oxidophenoxy)-3,5-diiodophenyl]propanoate;(2S)-2-amino-3-[4-(4-hydroxy-3-iodophenoxy)-3,5-diiodophenyl]propanoic acid

• 分子结构分类: 有机化合物 - 有机酸及其衍生物 - 羧酸及其衍生物
• 英文名称: disodium;(2S)-2-amino-3-[4-(3,5-diiodo-4-oxidophenoxy)-3,5-diiodophenyl]propanoate;(2S)-2-amino-3-[4-(4-hydroxy-3-iodophenoxy)-3,5-diiodophenyl]propanoic acid
• 化学式: C30H21I7N2Na2O8
• 分子量: 1471.8
• InChiKey: LKYWLLWWYBVUPP-XOCLESOZSA-L

计算性质

• 辛醇/水分配系数(LogP)：
  -0.15
• 重原子数：
  49
• 可旋转键数：
  8
• 环数：
  4.0
• sp3杂化的碳原子比例：
  0.13
• 拓扑面积：
  191
• 氢给体数：
  4
• 氢受体数：
  10

ADMET

毒理性

• 在妊娠和哺乳期间的影响

◉ 母乳喂养期间使用概述：Liotrix 是左甲状腺素（T4）和三碘甲状腺原氨酸（T3）的混合物，它们是人类乳汁的正常成分。关于在母乳喂养期间补充外源性左甲状腺素的数据有限，表明对婴儿没有不良影响。目前尚无关于在母乳喂养期间使用外源性三碘甲状腺原氨酸的信息。美国甲状腺协会建议，对于希望在哺乳期进行母乳喂养的患有亚临床和明显甲状腺功能减退的妇女，应使用左甲状腺素进行治疗。[1] 与孕前需求相比，桥本甲状腺炎患者在产后期的甲状腺剂量需求可能会增加。[2] ◉ 对哺乳婴儿的影响：尚未有关于母亲使用外源性甲状腺激素对婴儿影响的报告。已经报告了一例通过母乳喂养似乎缓解了甲状腺功能减退婴儿的克汀病的案例，但乳汁中的甲状腺激素量并不理想，[9] 这一结果也受到了争议。[10] 非常早产儿的母亲的乳汁中的甲状腺激素含量似乎不足以影响婴儿的甲状腺状态。[11] 乳汁中的甲状腺激素量显然不足以干扰甲状腺功能减退的诊断。[12] 在一项电话随访研究中，5位哺乳母亲报告称她们服用了左甲状腺素（剂量未指定）。这些母亲报告她们的婴儿没有不良反应。[13] 一位接受过甲状腺切除术的母亲每天服用100微克的左甲状腺素以及碳酸钙和钙三醇。她的母乳喂养的婴儿在3个月大时据说“生长得很好”。[14] ◉ 对哺乳和乳汁的影响：正常的哺乳需要足够的甲状腺激素血清水平。补充甲状腺功能减退导致的甲状腺水平不足应改善乳汁生产。超生理剂量的甲状腺激素不会预期进一步改善哺乳。

◉ Summary of Use during Lactation:Liotrix is a mixture of levothyroxine (T4) and liothyronine (T3), which are normal components of human milk. Limited data on exogenous replacement doses of levothyroxine during breastfeeding indicate no adverse effects in infants. No information is available on the use of exogenous liothyronine during breastfeeding. The American Thyroid Association recommends that subclinical and overt hypothyroidism should be treated with levothyroxine in lactating women seeking to breastfeed.[1] Thyroid dosage requirement may be increased in the postpartum period compared to prepregnancy requirements patients with Hashimoto's thyroiditis.[2] ◉ Effects in Breastfed Infants:Effects of exogenous thyroid hormone administration to mothers on their infant have not been reported. One case of apparent mitigation of cretinism in hypothyroid infants by breastfeeding has been reported, but the amounts of thyroid hormones in milk are not optimal,[9] and this result has been disputed.[10] The thyroid hormone content of human milk from the mothers of very preterm infants appears not to be sufficient to affect the infants' thyroid status.[11] The amounts of thyroid hormones in milk are apparently not sufficient to interfere with diagnosis of hypothyroidism.[12] In a telephone follow-up study, 5 nursing mothers reported taking levothyroxine (dosage unspecified). The mothers reported no adverse reactions in their infants.[13] One mother with who had undergone a thyroidectomy was taking levothyroxine 100 mcg daily as well as calcium carbonate and calcitriol. Her breastfed infant was reportedly "thriving" at 3 months of age.[14] ◉ Effects on Lactation and Breastmilk:Adequate thyroid hormone serum levels are required for normal lactation. Replacing deficient thyroid levels should improve milk production caused by hypothyroidism. Supraphysiologic doses would not be expected to further improve lactation.

来源:Drugs and Lactation Database (LactMed)

吸收、分配和排泄

• 消除途径

甲状腺激素主要通过肾脏消除。

Thyroid hormones are primarily eliminated by the kidneys.

来源:DrugBank