Thyroid pharmacology

Question 1

levothyroxine

Answer 1

T4 replacement for deficiency - peak after 12 days, fewer side effects

Question 2

triiodothyroxine, liothyroxine

Answer 2

T3 replacement for deficiency - immediate effect, more side effects, emergency only

Question 3

NaI, KI

Answer 3

hypothyroidism

Question 4

carbimazole, methinimazole

Answer 4

inhibit t3/ 4 release from follicles by inhibition of thyroperoxidase (dec. iodination of thyroglobulin)

side effects: hypothyroidism, GI, infection (agranuloytosis, neutropenia, thrombocytopenia) –> bleeding and easy bruising

Question 5

reduce mass and vascularisation of thyroid pre-removal

Answer 5

high dose iodide

Question 6

thyroidectomy

Answer 6

treat with t4

Question 7

propranolol

Answer 7

reduce sensitivity to catecholamines in hyperthyroidism

Question 8

radioiodine

Answer 8

beta radiation destroys thyroid

Question 9

lithium

Answer 9

reduce iodination of thyroglobulin

Question 10

amiadarone

Answer 10

anti arrhythmic - increase iodide

Question 11

tetracoside

Answer 11

acth analogue to test adrenal function (no improvement in function in Addison’s - autoimmune destruction)

Question 12

hydrocortisone

Answer 12

treat adrenal insufficiency

Question 13

metyrapone, trilostane

Answer 13

cushings - inhibit synthesis of cortisol

Question 14

sermorelin

Answer 14

test GH function (ghrh analogue)

Question 15

somatotropin

Answer 15

treat gh deficiency

Question 16

lancreotide, ocreotide

Answer 16

treat gh overactivity (somatostatin analogue)