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| ==Medical Therapy== | | ==Medical Therapy== |
| In euthyroid sick syndrome emphasis is on rapid correction of underlying disease. Many seriously ill patients have low levels of thyroid hormones but are not clinically hypothyroid and do not require thyroid hormone supplementation. Replacement of thyroid hormones in euthyroid sick syndrome is controversial except, in patients of congestive heart failure where liothyronine (LT3) or levothyroxine (LT4) may be recommended, to improve ventricular performance. Therefore, thyroid hormone therapy is generally not recommended for patients with euthyroid sick syndrome, except possibly those with chronic heart failure.<ref name="PingitoreLandi2005">{{citejournal|last1=Pingitore|first1=Alessandro|last2=Landi|first2=Patrizia|last3=Taddei|first3=Maria Chiara|last4=Ripoli|first4=Andrea|last5=L’Abbate|first5=Antonio|last6=Iervasi|first6=Giorgio|title=Triiodothyronine levels for risk stratification of patients with chronic heart failure|journal=The American Journal of Medicine|volume=118|issue=2|year=2005|pages=132–136|issn=00029343|doi=10.1016/j.amjmed.2004.07.052}}</ref> | | In euthyroid sick syndrome emphasis is on rapid correction of underlying disease. Many seriously ill patients have low levels of thyroid hormones but are not clinically hypothyroid and do not require thyroid hormone supplementation. Replacement of thyroid hormones in euthyroid sick syndrome is controversial except, in patients of congestive heart failure where liothyronine (LT3) or levothyroxine (LT4) may be recommended, to improve ventricular performance. Therefore, thyroid hormone therapy is generally not recommended for patients with euthyroid sick syndrome, except possibly those with chronic heart failure.<ref name="PingitoreLandi2005">{{citejournal|last1=Pingitore|first1=Alessandro|last2=Landi|first2=Patrizia|last3=Taddei|first3=Maria Chiara|last4=Ripoli|first4=Andrea|last5=L’Abbate|first5=Antonio|last6=Iervasi|first6=Giorgio|title=Triiodothyronine levels for risk stratification of patients with chronic heart failure|journal=The American Journal of Medicine|volume=118|issue=2|year=2005|pages=132–136|issn=00029343|doi=10.1016/j.amjmed.2004.07.052}}</ref> |
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| *Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
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| *Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
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| *Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
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| *Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
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| ===Disease Name===
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| * '''1 Stage 1 - Name of stage'''
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| ** 1.1 '''Specific Organ system involved 1'''
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| *** 1.1.1 '''Adult'''
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| **** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)'''
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| **** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
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| **** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
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| **** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
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| **** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
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| **** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
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| *** 1.1.2 '''Pediatric'''
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| **** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
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| ***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose)
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| ***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
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| ***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
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| ***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
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| ***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
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| ****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
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| ***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h(maximum, 100 mg per dose)
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| ***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
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| ***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
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| ***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
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| ** 2.1 '''Specific Organ system involved 2'''
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| *** 2.1.1 '''Adult'''
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| **** Preferred regimen (1): [[drug name]] 500 mg PO q8h
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| *** 2.1.2 '''Pediatric'''
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| **** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
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| * 2 '''Stage 2 - Name of stage'''
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| ** 2.1 '''Specific Organ system involved 1 '''
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| **: '''Note (1):'''
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| **: '''Note (2)''':
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| **: '''Note (3):'''
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| *** 2.1.1 '''Adult'''
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| **** Parenteral regimen
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| ***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
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| ***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
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| ***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
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| **** Oral regimen
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| ***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
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| ***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
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| ***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
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| ***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
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| ***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
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| ***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
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| *** 2.1.2 '''Pediatric'''
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| **** Parenteral regimen
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| ***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
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| ***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
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| ***** Alternative regimen (2): [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
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| **** Oral regimen
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| ***** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
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| ***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
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| ***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
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| ***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
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| ***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
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| ***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
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| ** 2.2 '<nowiki/>'''''Other Organ system involved 2''''''
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| **: '''Note (1):'''
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| **: '''Note (2)''':
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| **: '''Note (3):'''
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| *** 2.2.1 '''Adult'''
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| **** Parenteral regimen
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| ***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
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| ***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
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| ***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
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| **** Oral regimen
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| ***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
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| ***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
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| ***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
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| ***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
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| ***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
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| ***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
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| *** 2.2.2 '''Pediatric'''
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| **** Parenteral regimen
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| ***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
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| ***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
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| ***** Alternative regimen (2): [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
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| **** Oral regimen
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| ***** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
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| ***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
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| ***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
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| ***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
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| ***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
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| ***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
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| ==References== | | ==References== |