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Pharmacology > (Anti-) Thyroid > Flashcards

(Anti-) Thyroid Flashcards

1
Q

concept: how do thyroid hormones increased BMR

A

increases BMR via Na/K ATPase = increases resp rate, increases temperature, increases O2 consumption

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2
Q

concept: effect of thyroid hormones on catecholamines

A

increases sympa activit = increase Co and HR

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3
Q

concept: effet of thyroid on brain

A

development

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4
Q

Where do you find 5’iodinase (not relaly important for this i dont think)

A 
peripheral tissue
liver
kidney
pituitary gland
brain
brown fat
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5
Q

describe receptors fo TRH – TSH – T3/T4

A

TRH - IP3
TSH - cAMP
T3/T4 - nuclear

(Words get bigger as you go furhter down chain)

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6
Q

What is levothyroxine

A

longet t1/2 T4

LEVO has four letters - thyroxine

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7
Q

What is Liothyronine

A

shorter t1/2 T3

LIO has three letters - thyronine

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8
Q

A/se of levothyroxine and liothyronine

A

tremors, tachycardia, arrhtymias, heat intolerace ie hyperthyroidism

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9
Q

effects of rifampin, phenobarbital and phenytoin on levels of T3 and T4

A

induce P450 blleeehhh so increased metabolism so less thyroid hormone

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10
Q

I say Queen Anne

A

you say laterla third eyeborw loss

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11
Q

Name the Thioamides

A

Propylthiouracil

methimazole

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12
Q

~*~MOA of propylthiouracil and methimazole

A

block idination of thyroglobulin and inhibit coupling reaction = reduced T3 and T4

inhibit thyroperoxidase so decreased new T3 adn new T4 but not preformed.

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13
Q

Preferred drug in thyroid storm and why please

A

propylthiouracil
bc

1) inhibits 5-deiodinase – decreased conversion from T4 to T3

(methimazole does not do this)

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14
Q

~*~A/se of thiamide, propylthiouracil

A

propylthiouracil = rash, agranulocytosis, aplastic anemia, hepatotoxicity, vasculitis

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15
Q

~*~A/se of thiamide, metimazole

A

less severe, and therefore more preferred in clinical setting
POSSIBLE TERATOGEN

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16
Q

WOLFF CHAIKOFF!!

A

iodide at high levels inhibit organification and release = lower levels, but this wanes at 10-14 days and therefore is not used for long term treatment

17
Q

Used of Iodine and Iodide salts

A

decreases vascularity and size of gland – used before surgery before excision

and tyrotoxicosis cirisis with propylthiouracil and beta blockers

18
Q

Three drugs used in thyrotoxic crissi

A

propylthiouracil
Iodine/Iodide salts
beta blockers

19
Q

Describe the prepartions available for iodine and iodide salts

A

1) lugol solution - iodine and potassium iodide

2) saturated solution of potassium iodide only

20
Q

THyroid storm again. the lecture just keeps adding drugs

A

propylthiouracil
iodine/iodide salts
beta blcokers - nadolol, atenolol

21
Q

MOA propanolol

A

non specific bb

**prevents conversion of T4 to T3

22
Q

MOA esmolol

A

short acting BB

control intraoperative thyroid storm

23
Q

DOC at intraoperative thyroid storm

A

esmolol

24
Q

DOC at thyroid storm in patients with asthma

A

diltiazem - calcium channel blocker

SHARK flashback – can complicate diabetic treatment by causeing hyperglycemia in diabetics

25
Q

What do you give to prevent peripheral conversion of T4 to T3 in thyroid storm

A

holy monkeys thyroid storm

propylthiouracil
IV sodium iodine
glucocorticoids
bb
diatrizoate and iohexol
26
Q

MOA of diatrizoate and iohexol

A

iodinated radiocontrast medial that suupresses action fo 5’iodinase - no conversion of T4 to T3

use at tyrotoxicosis to decreased T3 concentraiton

27
Q

Perchlorate
Thiocyanate
Pertechenetate
MOA

A

inhibit iodide concentation in gland by blockign transportation

28
Q

Why do we care about amiodarone

coat of many colours

A

structural similarity with thyroxine

a) iodine associated hyperthyroidism
b) autoimmune mediated inflammatory version <– treat with steroids
c) hypothyroidism due to blockade of T4 to T3

29
Q

How to treat iodine associated hyperthyroidism caused by amiodarne

A

thiamides - propylthiouracil and metimazole

30
Q

Lithium affect on thyroid style

A

inhibits release of hormones (hypothyroidism) and causes thyroid enlargement

31
Q

Name some drugs that provoke autoimmune or destructive inflammatory thyroiditis to induce hypothyroidism

A

a) amiodarone
b) IFNalpa
c) IL-2
d) Litihium

32
Q

What do these drugs have in common

a) amiodarone
b) IFNa
c) IL-2
d) Lithium

A

all provoke autoimmune or destructive inflammatory thyroidiits resulting in hypothyroidism

33
Q

SHARK: Name three drugs that inhibit conversion of T4 to T3

A

corticosteroids
propranolol
amiodarone

34
Q

Name some goitrogens

A

cabbage - thiocyantae (prevents uptake of I)

cassava - carbs _ thioc;yanate (prevents uptake of I with perchlorate and pertechetol)

Pharmacology (70 decks)

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