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1.11

Thyroid Hormones

TermDefinition
Thyroid gland producing hormone 1 triiodothyronine (T3)
Thyroid gland producing hormone 2 tetraiodothyronine (T4)
Thyroid gland producing hormone 3 calcitonin
2 pathways of synthesis and processing of thyroid hormone: 1. basolateral 2. apical
what activates the hypothalamic-pituitary-thyroid axis exposure to cold may activate it
hypothalamic-pituitary-thyroid axis: TRH stimulates release of TSH from pituitary thyrotropes. SST and dopamine inhibit it
what stimulates synthesis of hypothalamic-pituitary-thyroid axis TSH and small amounts of iodide
what inhibits synthesis of hypothalamic-pituitary-thyroid axis large amounts of iodine
T4 or thyroxine most prevalent
T4 or thyroxine has high affinity for plasma binding proteins
T3 is the physiologically active form
Is T4 or T3 more potent? T3 is 3-4x more potent
Reverse T3 action-partial agonist
Thyroid hormone mechanism and effects T3 (nuclear receptor) induces new proteins synthesis which produces effects of thyroid hormone
2 disruptions of thyroid homeostasis: hypothyroidism and hyperthyroidism
iodine deficiency and goiter cascade low iodine, not enough to make T3/T4, low levels T3/T4, stimulate hypothalamus and pituitary for TRH and TSH secretion
TSH can promote _______ which causes goiter (irregular growth) hyperplasia and hypertrophy of thyroid gland
hypothyroidism: treatment (thyroid hormone replacement therapy)--> Synthetic T4 (thyroxine) synthroid
hypothyroidism: treatment (thyroid hormone replacement therapy)--> Synthetic T3 (liothyronine) cytomel
hypothyroidism: treatment (thyroid hormone replacement therapy)--> "natural thyroid" contains both T3 and T4
hypothyroidism: thyroid hormone replacement ADR instruct patients to watch for symptoms and notify PCP if they occur transient alopecia pseudotumor cerebri seizures
hypothyroidism: thyroid hormone replacement drug interactions 1. increase effects of anticoagulants (monitor INR) 2. increase cardiac effects of sympathomimetics, tricyclic antidepressants (decrease dose) 3. blood glucose control drugs (may need to increase ) 4 decrease effects of beta blockers (increase dose)
hypothyroidism DRUG: Levothyroxine: patient counseling point take on an empty stomach
hyperthyroidism-drug interaction with thyroid hormone biosynthesis: Thioamides interfere directly with the synthesis of thyroid hormones
hyperthyroidism-drug interaction with thyroid hormone biosynthesis: Radioactive Iodine damages gland via selective uptake followed by local radiation damage
hyperthyroidism-drug interaction with thyroid hormone biosynthesis: B-receptor ANTAGONISTS control the manifestations, CCBs are alternative drug
Hyperthyroidism DRUG: Thioamides MOA 1. prevents thyroid hormone synthesis by INHIBITING thyroid peroxidase (TPO) 2. Propylthiouracil inhibits peripheral deiodinase (converting T4 to T3)
Hyperthyroidism- Radioactive Iodine: most often used isotope I(131)- emits beta particles (99%) and gamma rays (1%)
Hyperthyroidism-Radioactive iodine Beta particles (99%) localized destructions, radioactive/chemical ablation (can destroy thyroid cells with little damage to surrounding tissues)
Hyperthyroidism DRUG: B-adrenergic Receptor ANTAGONISTS Propranolol (INDERAL)
Hyperthyroidism DRUG: Propanolol (INDERAL) MOA (2) 1. antagonizes the SNS symptoms 2. blocks periopheral conversion of T4 to T3
Many symptoms of hyperthyroidism are associated with: Sympathetic stimulation
Created by: megangodfrey97
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