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Endocrine Pharm > Thyroid/Antithyroid Drugs > Flashcards

Thyroid/Antithyroid Drugs Flashcards

1
Q

What drugs are in the Thyroid Preparatios category?

A

Levoxythyroxine T4
LiothyroxineT3
Liotrix mix T3, T4

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2
Q

What are the steps of biosynthesis of TH?

A

Iodine uptake into Thyroid gland
Peroxide Mediated Ox of Iodide to Iodine
Iodination of Tyrosine (MIT, DIT)
Molecules of MIT and DIT are combined to form thyroid hormones

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3
Q

What is combined to form T3 and T4?

A

MIT + DIT =T3

DIT + DIT =T4

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4
Q

How are T hormones secreted?

A

Tgb is taken up by Thy cell.
Degradation of Tgb releases thy hormone
5:1 ratio of T4:T3

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5
Q

What form is thy hormone transported in?

A

Bound to Thyroxine binding globulin

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6
Q

What is the mechanism of Thyroid hormine(present)?

A

Hormone transported into the cell. T3 binds directly to Monomer of TR while T4 needs to be converted to T3 by 5’- DEIODINASE(5DI)

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7
Q

What is the mechanism of Thyroid hormine(absent)?

A

Homo-dimerof receptor is bound to TRE.

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8
Q

How is secretion of TH regulated?

A

TRH promotes release of TSH. TSH promotes release of T3 + T4. Decreased by negative feedback at Hyp and Pit.
High Iodide inhibits. low iodide promotes

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9
Q

What are the physiological effects of Thyroid hormone?

A 
SNS- Inc Beta, Dec alpha
Growith- Inc
Therm- Inc
RepGI- pro
Skin/Hair- growth
Edema
Cardio- Inc HR
Metabolic- Inc BMR
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10
Q

What are the effects of Hyper/Hypothyroidism on the body?

A 
SNS- Inc Beta adr, Dec alpha adr
Growith- Inc
Therm- Inc
RepGI- pro
Skin/Hair- growth
Edema
Cardio- Inc HR
Metabolic- Inc BMR
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11
Q

What are the Type 1 causes of HypoT?

A

Congenital (cretinism)
Autoimmune thyroiditis (hashimotos)
Iodine Deficiency
Other: Surg, rad, meds

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12
Q

What are the Type 2 causes of HypoT?

A

Impaired TSH production

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13
Q

What is the Tx of Hypothyroidism?

A 
Hormone replacement with Thyroid hormone.
Levoxythyroxine
-more stable
-low cost
-easy lab measurement 
-7 day HL
-yeilds T3-T4
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14
Q

What are the adverse effects of Thyroid Hormone?`

A

Hyper thyroidism
Child: restlessness, insomnia, accelerated bone maturation
Adult: Nervousness, heat intolerance, heart palp, wt loss
Geriatric: atrial fib, osteoporosis

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15
Q

What are the differenced between Levothyroxine(T4) and Liothyronine(T3)?

A

T4 longer T1/2

T3 more potent

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16
Q

What are the causes of Primary Hyperthyroidism?

A 
Graves disease
Thyroid adenoma
Autoimmune thyroiditis (hashimotos)
Thyroid Storm (fatal!)
Excess Iodide (usually accompanies underlying thyr. Disease)
17
Q

What are the causes of Secondary Hyperthyroidism?

A

Dysfunction of Hypothalamus or pituitary.

18
Q

What are the treatments of Hyperthyroidism?

A

Methimazole

Propylthiouricil

19
Q

What are the Adverse effects of Methimazole and PTU?

A

Can cross the Placenta
Can cause a fatal hepatitis. (PTU not for someone with altered Liver funct.
Methimazole? Altered taste and smell

20
Q

What antithyroid med is better for Pregnant females? THyroid storm?

A

PTU because it is protein bound

21
Q

What are the Iodide drugs used for Antithyroid?

A

Potassium Iodide

Lugol’s Solution

22
Q

What is the MOA of Thioamines?

A

Inhibits Peroxidase Reaction, Iodine organification, and coupling of iodotyrosines

23
Q

Waht is the MOA of Iodides?

A

Inhibits hormone release by inhibiting proteolysis of Tgb.

24
Q

What are the uses of Iodides?

A

Only inhibits for 2-8 weeks.

Good as a pre surgery drug because it decreases vascularity, size and fragility of the hyperplastic gland.

25
Q

What are the Adverse effects of Iodides

A

Non-specific. Don’t feel good.

26
Q

What is the MOA of Radiocative Iodine?

A

B rays destroy parenchymal cells of the tyroid

Gamma rays pass through tissue to detect conc. of RAI remaining in Thyroid

27
Q

Waht are the Anion Inhibitors

A

Perchlorate
Pertechnetate
Thiocyanate

28
Q

How can effects of Anion inhibitors be counteracted?

A

Large dose of Iodide

29
Q

What are the Adverse effefts of Anion Inhibitors?

A

Perchlorate can cause aplastic Anemia

30
Q

Waht are the key adjuncts of Thyroid Tx?

A 
Propanolol
Atenolol
Metoprolol
Diltiazem
Barbiturates
Bile acid sequestrants

Endocrine Pharm (11 decks)

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