Thyroid Hormone + Glucocorticoids Flashcards
Thyroid hormone function
Controls the metabolic activity of the heart, muscle, digestive function, brain development and bone maintenance
Hypothyroidism Treatment
- LEVOTHYROXINE, LIOTRIX, LIOTHYRONINE
- MOA: Synthetic T4: Thyroid hormone increases basal metabolic rate
- Adverse: Nervousness, insomnia, palpitations, arrhythmia, nausea, sweating. Mimics hyperthyroidism effects
Hyperthyroidism Treatment
- Causes: Grave’s Disease and excessive use of synthetic thyroid hormone
- Thiomides and iodides
Thiomides
- METHIMAZOLE, PROPYLTHIOURACIL
- MOA: Inhibits thyroid peroxidase. Blocks thyroid hormone synthesis
- Adverse: nausea, vomiting, ulocytosis, skin rash, itching
Iodides
-Potassium Iodide and Sodium Iodide
MOA: Inhibits the release of thyroid hormone. HIGH doses needed
-Only used for about 2 weeks
-Adverse: metallic taste, mouth burning, salivation, rash, cough
-Going to occur before the surgery to remove the thyroid
Radioactive Iodide
-131 I-sodium iodide (given orally, concentrated in thyroid gland
MOA: Releases beta particles which destroy thyroid tissue. NON surgical thyroidectomy
-Advantages: Can “cure” hyperthyroidism, easily administered, inexpensive, no pain
Adverse: Nausea and vomiting, irritability, nervousness
Cortisol Anti-Inflammatory Effects
- Reduces pain, swelling, redness, warmth
- Inhibit production and release of inflammatory and immune mediators including prostaglandins, leukotrienes, interleukins and histamine
- Suppress leukocyte infiltration and movement into inflamed tissues
Addison’s disease
Adrenal atrophy with reduced CORTISOL and ALDOSTERONE production causing weakness, muscle wasting, hypoglycemia, electrolyte imbalances, reproductive changes, hypoatremia, hypotension. LOW DOSE CORTISOL GIVEN
High Dose Glucocorticoid Treatment
- Can suppress inflammation in rheumatoid arthritis, asthma and other conditions.
- Suppress immune response in organ transplants. Reduce organ rejection.
- Dermatological disorders including dermatitis, psoriasis and others
- Control allergic reactions in rhinitis, bee stings, drug allergy etc
Glucocorticoid Drugs
CORTISONE, HYDROCORTISONE, PREDNISONE, DEXAMETHASONE
-MOA: binds to the glucocorticoid receptor leading to downstream effects used to treat immune or inflammatory disease processes.
Side Effects w Chronic Therapy
- Can be caused by too much corticosteroid in the system or a disease process
- Effects are: osteoporosis, increased infections, myopathy, sodium and water retention, psychologic alterations (insomnia, anxiety, agitation), cataracts and glaucoma, Cushing’s syndrome
Contradictions and Precautions
-Use in caution with hypertension, renal impairment, peptic ulcer, diabetes mellitus, osteoperosis
