Antithyroid Flashcards
What is the process of thyroidglobulin synthesis?
Iodide is taken into the cell—(thyroid peroxidase)—>iodine–(organification)–>MIT and DIT–(coupling)–>T3/T4
How is 131 I used? When shouldn’t we use it?
Beta radiation of 131 I—>destruction of thyroid
Avoid young kids and pregnancy
What drugs block thyroid peroxidase and thus treat hyperthyroidism?
PTU/methimazole/carbimazole
What drugs block deiodinase (convert T4 to T3)
Propranolol and PTU
What is the side effect of PTU/methimazole/carbimazole? and why is methimazole is used more than PTU now?
Agranulocytosis
Because PTU can cause liver failure
Which drug is used for hyperthyroidism in pregnant women? why?
PTU
PTU is highly protein bound—>unlikely to cross placenta
What are the synthetic T4 and T3 and which one is used for acute hypothyroidism?
T4–>levothyroxine
T3—>liothyroxine
Liothyroxine is used for acute condition
What is Lugol solution and what is it used for? and what is its disadvantage?
Potassium iodide + iodine—>for thyrotoxicosis
It stops working after 10-14 days
What are the synthetic ADH and ACTH?
ADH—>demopressin
ACTH—>cosyntropin
What are the 2 drugs that can be used for hyperprolactinemia?
Bromocriptine and cabergoline
How to distinguish central and nephrogenic diabetes insipidus?
Give desmopressin—>if response to it—>central
If not—>nephrogenic
What else can desmopressin be used for?
Hemophilia A/vW disease/nocturnal enuresis
MOA of octreotide/usage/side effect?
Somatostatin analog
Carcinoid tumor/acromegaly/bleeding varices
Gallstone
What level would increase in pt with acromegaly?
GH and IGF-1
What drugs are used to treat SIADH and what are their MOA?
Block V2 receptor in collecting duct
Demeclocycline and tolvaptan
