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Pharamcology Endocrine > Thyroid and anti-thyroid > Flashcards

Thyroid and anti-thyroid Flashcards

1
Q

Which drugs inhibit the conversion of T4 to T3

A
  1. Propylthiouracil
  2. propranolol
  3. glucocorticoids
  4. iopanoic acid
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2
Q

What are the effects of hyperthyroidism (thyrotoxicosis)

A
  1. Increased basil metabolic rate, gluconeogenesis, gluconeogenesis
  2. Increased heart rate, cardiac output, arrhythmias, angina
  3. Decreased cholesterol, Triglycerides
  4. Nervousness and anxiety
  5. Muscle weakness, fatigue, increased tendon reflexes, hypercalcemia, osteoporosis
  6. Increased appetite, diarrhoea
  7. anaemia
  8. menstrual irregularities, increased fertility
  9. Periorbital Edema exopathalmos
  10. Warm moist skin, heat intolerance, thin hair
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3
Q

What effects of hypothyroidism myxoedema

A
  1. Decreased basal metabolic rate, hypoglycemia, hypercholesteremia, hypertriglyceridaemia
  2. decreased heart rate, low output cardiac failure, pericardial effusion
  3. Lethargic in mental retardation
  4. stiffness and muscle fatigue
  5. decreased appetite, constipation
  6. anaemia
  7. Menorrhagia, infertility, decreased libido, impotence
  8. puffy face, large tongue
  9. Pale, dry skin, intolerance to cold, brittle hair and nails.
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4
Q

Name the drugs used as replacement therapy in a hypothyroid states

A
  1. Levothyroxin sodium (T4)
  2. Liothyronine (T3)
  3. Combination of T4 and T3 (4:1)
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5
Q

What are the therapeutic uses of drugs used in hypothyroid states

A
  1. Cretinism and myxoedema- levothyroxine. 12.5 to 25 mcg per day for elderly impatient with coronary artery disease. 50 to 100 mcg for young adults
  2. Myxoedema Coma
  3. Benign thyroid nodule
  4. thyroid carcinoma
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6
Q

What is the treatment of myxoedema coma

A
  1. levothyroxine
  2. IV hydrocortisone
  3. rewarming with blankets
  4. correction of electrolyte imbalance
  5. ventilatory support may be required
  6. antibiotics if infection is the cause
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7
Q

Classify anti-thyroid drugs

A
  1. Thyroid hormone synthesis inhibitors
  2. Inhibitors Of iodide trapping
  3. hormone release inhibitors
  4. thyroid tissue destroying agents
  5. others
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8
Q

Name thyroid hormone synthesis inhibitors (thioamides or thiourea derivatives)

A

1. Propylthiouracil
2. Methimazole
3. Carbimazole

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9
Q

Name inhibitors of iodide trapping

A
  1. Thiocyanate
  2. Pirchlorates
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10
Q

Name hormone release inhibitors used in hyperthyroidism states

A
  1. Iodine
  2. iodides of sodium and potassium
  3. organic iodide
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11
Q

Name thyroid tissue destroying agent

A
  1. Radioactive iodine (131 I)
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12
Q

Name other drugs used in hyperthyroidism

A
  1. Propranolol
  2. atenolol
  3. diltiazem
  4. dexamethasone
  5. Metaprolol
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13
Q

What are the mechanisms of action of thioamides

A
  1. Inhibit thyroid peroxidase enzyme
  2. Inhibit iodination of tyrosine residues
  3. Inhibit coupling of iodotyrosine
    
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14
Q

Which thioamide Is most rapidly absorbed

A

Propylthiouracil

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15
Q

What metabolite is created from carbimazole

A

Methimazole

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16
Q

What are the adverse effects of anti-thyroids

A
  1. Skin rashes
  2. joint pain
  3. fever
  4. hepatitis
  5. nephritis
  6. agranulocytosis (rare)
  7. hypothyroidism
17
Q

What are the adverse effects of anti-thyroid drugs

A

thyrotoxicosis 

18
Q

Which type of anti-thyroids cannot be used clinically

A

Thiocynates and perchlorates which are inhibitors of iodide trapping

19
Q

Which two drugs can be used pre-operatively before thyroectomy and in thyroid storm

A

1. Lugols iodine
2. Ipodate sodium and iopanoic acid

20
Q

 What drug can be used for prophylaxis of endemic goitre

A

Iodized salt

21
Q

What are the side effects of using iodine 

A
  1. Type III Hypersensitivity reaction
  2.  headache, sneezing, irritation of eyes with swelling of eyelids
  3. Pulmonary oedema
  4. foetal goitre
22
Q

Which drug emmits beta particles and what is its function

A

Radioactive iodine. Beta particles cost destruction of follicular cells leading to fibrosis and correction of hyperthyroid state

23
Q

What are the contraindications of radioactive iodine

A

Pregnancy, children and nursing mothers

24
Q

What are the advantages of radioactive iodine

A

Permanently cures hyperthyroidism

25
Q

What is propranolol and other beta blockers used to treat hyperthyroidism

A

Prevents the conversion of T4 to T3

26
Q

What is thyrotoxic crisis/thyroid storm

A

Severe hypermetabolic state do the very high levels of circulating thyroid hormone. Symptoms are nausea, vomiting, diarrhoea, mental confusion, cardiac arrhythmias and hyperprexia

27
Q

Treatment of thyrotoxic crisis/thyroid storm

A
  1. Hospitalization
  2. supportive care
  3. Propylthiouracil administration via nasogastric tube
  4. Oral iodide to inhibit thyroid hormones
  5. propranolol IV or diltiazem
  6. Ivy Hydrocortisone- Inhibit conversion of T4 to T3 and corrects adrenal insufficiency

Pharamcology Endocrine (9 decks)

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