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318 CH 57

Drugs for Thyroid dysfunction

What are the 2 classes of drugs for hyperthyroidism? Antithyroid drugs: Thionamides. Radioactive iodine
What do Thionamides do? suppress thyroid hormone synthesis.
What are the 2 Thionamides? Propylthiouracil (PTU) and Methimazole [Tapazole]
PTU differs from methimazole in 2 major ways, what are they? shorter half-life and it poorly crosses placenta (preferred in pregnancy)
what is the mechanism of action for Propylthiouracil (PTU) blocks thyroid hormone synthesis in 2 ways: (1) PTU prevents the oxidation of iodine, thereby inhibiting the incorporation of iodine into thyrosine. (2) PTU prevents iodinated tyrosines from coupling
How long does it take for Propylthiouracil (PTU) to reach a euthyroid state? why?: PTU does NOT destroy existing stores of thyroid hormone, therefore it may take 3-12 weeks to produce euthyroid
how is Propylthiouracil (PTU) administered? Orally
how long does it take to see the therapeutic action of propylthiouracil (PTU) 30 minutes
what is Propylthiouracil (PTU) used for? hyperthyroidism
what are the adverse effects of propylthiouracil (PTU) agranulocytosis, hypothyroidism
which of the antihyperthyroidism drugs is preferred in pregnancy/lactation? PTU
PTU and Methimazole [Tapazole] are very similar, in what ways are they different? Methimazole [Tapazole] has a longer half-lief (1x/day), it does not block conversion of T4 into T3 in the periph (slower onset), crosses placenta more readily than PTU and has a higher concentration in breast milk.
which between PTU and Methimazole [Tapazole] is preferred? in pregnancy, PTU. otherwise Methimazole [Tapazole] is preferred because it has 1x/day dosing.
what is iodotope? radioactive iodine used in hyperthyroidism.
how long does it take for the effects of idotope to become aparent? how long for it to reach full effects? effects are aparent in a few days/weeks and full effects are apparent in 2-3 months.
what is a common complaint by pts on iodotope? hypothyroidism
what is used to treat hypothyrodism? Levothyroxine (T4) [Synthroid]
what is the mechanism of action in Levothyroxine? Levothyroxine is identical to Human T4. it is converted to T3 just like normal T4 and thus produces normal levels of BOTH T3 and T4.
what is Levothyroxine used for hypothyroidism
adverse effects of levothyroxine: Acute overdose (thyrotoxicosis). Chronic overdose (accelerated bone loss and increased fisk for A.fib)
what are some drugs that decrease the absorption of levothyroxine? Questran, Colestid, Calcium supplements(TUMS), Carafate, albuminum-containing antacids (Maalox, Mylanta) and iron supplements
how far should you separate the administration of levothyroxine and drugs that reduce its absorption? by 4 hours
what are some drugs that accelerate the metabolism of levothyroxine? Dilantin, Tegretol, Rifadin, Zoloft, Phenobarbital
How to levothyroxine and Warfarin interact? warfarin effects are enhanced
how do levothyroxine and catecholamines interact? there is an increased risk for catecholamine-induced dysrhythmias
Created by: 1398660434