AGENTS FOR THYROID DISORDERS

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AGENTS FOR THYROID DISORDERS

• Citation Dr. Walters note packet.

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• The thyroid gland secretes which 3 hormones?
• 1. triiodothyronine (T3) liothyronine
• 2. tetraiodothyronine (T4) thyroxine
  levothyroxine
• 3. calcitonin what stimulates its secretion?
• Increased Ca
• What hormone regulates the thyroid gland?
• TSH from ant. Pituitary
• What hormone regulates TSH?
• TRH from hypothalamus

3

• What Rx is human recombinant TSH and is used as a
  diagnostic aid?
• Thyrotropin Alpha
• What Rx is used to tx hyperthyroidism and thyroid
  carcinoma?
• Na Iodide 131
• What Rx is used to assess pituitary and thyroid
  fxn?
• Protirelin
• What Rx is used to dx thyroid fxn?
• Na Iodide 123
• What Rx is used to assess the integrity of the
  Iodide uptake pump?
• Thyrotropin alpha what else is it used for
• To promote radio iodide uptake in the tx of
  carcinoma

4

• What Rx interacts with ASA and L-DOPA?
• Protirelin
• What Rx is pregnancy category X?
• Na Iodide 131
• What are the functions of T3, T4?
• 1. stimulate protein synthesis during
  development
• 2. increase O2 consumption ? incr BMR
• Hypothyroidism during neurogenesis which ? decr
  expression of Myelin Basic Protein is called
• Cretinism characterized by
• Mental retardation
• dwarfism

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• T3, T4 do not incr O2 consumption in which
  tissues?
• Brain, testes, spleen
• 30-40 of the incr in BMR is due to
• Stimulation of cardiac contractility
• In the U.S., hypothyroidism is usually due to
• Hashimotos thyroiditis
• Most common consequence of hypothyroidism?
• Goiter mech?
• Decr T3, T4 ? decr negative feedback to ant
  pituitary ? incr TSH ? incr thyroglobulin ?
  hypertrophy of thyroid
• Severe hypothyroidism is called?
• Myxedema Gulls dz

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• Rxs for hypothyroidism
• What is the preferred form of thyroid hormone?
• Levothyroxine (synthetic T4) why?
• Less side effects b/c the body converts T4 to T3
  as needed
• What is the name for synthetic T3?
• Liothyronine
• What Rx is a 41 mixture of T4T3?
• Liotrix
• What Rx has variable absorption (affected by
  food)?
• Levothyroxine
• What are the uses for Levothyroxine?
• 1. Primary hypothyroidism
• 2. Myxedema Coma (medical emergency)
• 3. to suppress TSH or thyroid gland in cases of
  hyperthyroidism

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• Rxs for hyperthyroidism
• What is the most common cause of hyperthyroidism?
• Graves dz which is?
• toxic diffuse goiter IgG against TSH receptor
  agonize and stimulate TSH receptors ?
• Increased release of T3, T4
• What Rx has high energy beta particles that
  destroy the thyroid gland from inside (used for
  hyperthyroidism and thyroid CA)?
• Na Iodide 131
• What is the MOA of Propylthiouracil (PTU)?
• 1. inhibits thyroperoxidase in the thyroid gland
• 2. inhibits deiodinase in periphery
• What Rx inhibits thyroperoxidase?
• Methimazole the inhibition of thyroperoxidase
  in turn inhibits
• A. Oxidation of I- to higher state
• B. Organification
• C. Coupling of MIT and DIT

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• What Rx has Anti Vitamin K activity?
• PTU
• What are the uses for Iodine?
• 1. preop to thyroidectomy
• 2. thyrotoxic crisis
• 3. nuclear accidents
• What Rx can cause reversible agranulocytosis?
• Methimazole
• What Rx can potentiate anticoagulant tx?
• PTU b/c anti vitamin K
• What Rx (at hi doses) inhibits organification and
  coupling (wolff-chaikoff effect)?
• Iodine
• What are 3 Adjuvant tx?
• Propranolol
• Dexamethaxone
• Ca channel blockers
• Which Rx has immunosuppressant effects?