Zweig Susan B, Schlosser Jonathan R, Thomas Sylvia A, Levy Carol J, Fleckman Adrienne M
Department of Medicine, Division of Endocrinology and Metabolism, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, New York 10003, USA.
Endocr Pract. 2006 Jan-Feb;12(1):43-7. doi: 10.4158/EP.12.1.43.
To report the successful management of thyrotoxicosis in a seriously ill 47-year-old man with a perforated gastric ulcer in whom oral intake was contraindicated.
Our patient was treated with 400 mg of propylthiouracil (PTU) every 6 hours in the form of specially prepared suppositories for rectal administration, together with intravenously infused esmolol.
We were able to demonstrate substantial absorption of PTU administered by means of rectal suppositories. Serum levels of PTU were maintained within the high therapeutic range for 5 days until the patient was able to tolerate orally administered therapy. The patient improved clinically during this treatment.
This case strongly supports the rectal administration of PTU in suppository form as an appropriate alternative route in any patient with thyrotoxicosis, including the critically ill patient, when oral administration is not possible.
报告一名47岁患有胃溃疡穿孔的重症男性患者甲状腺毒症的成功治疗情况，该患者禁忌经口摄入。
我们的患者每6小时接受400毫克丙硫氧嘧啶（PTU）治疗，采用专门制备的直肠给药栓剂形式，并静脉输注艾司洛尔。
我们能够证明经直肠栓剂给药的PTU有大量吸收。PTU血清水平在高治疗范围内维持了5天，直到患者能够耐受口服治疗。在此治疗期间患者临床症状改善。
该病例有力地支持了以栓剂形式直肠给药PTU，作为任何甲状腺毒症患者（包括重症患者）在无法口服给药时的合适替代途径。
