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NURS 572 Pharm 57

Pharm Ch 57 thyroid drugs

physiology of thyroid gland uses enzyme peroxidase to trap inoranic iodine, which then combines with tyrosine to for T3 and T4
T3 triiodothyronine
T4 tetraiodothyronine
functions of thyroid hormone increase metab, generate heat, stimulate heaert (HR, FoC, CO), promote growth/development (esp brain, NS, sk mus)
endocrine control of thyroid hypothal --- ant pit ---thyroid --- T3/T4
hypothyroid diseases in non-pregnant adults --> myxedema. can be in pregnant women, infants.
hyperthyroid diseases Graves (TSIs autoimmune hyper-thyroid secretion), Plummer's disease (toxic nodular goiter), thyrotoxicosis
What is Hashimoto's hypthyroiditis usually auto-immune when iodine is not deficient. puffy, pale, alopecia, cool/dry skin, slowed metab, cold intolerance
what is cretinism hypothyroidism in children --> mental/physical retardation
Grave's Disease TSIs bind thyroid --> oversecretion T3/T4 --> wakeful, warm/moist skin, tachy, heat intol, inc appetite with dec weight, poss exophtalmos/goiter
thyroid storm/thyrotoxicosis extreme hyperthyroidism with extreme manifestations
Plummers disease adenoma --> hyperthyroidism --- same manifestations without exophthalmos
drugs for hypothyroidism levothyroxine T4, iodothyronine T3
what is preferred drug for hypothyroidism levothyroxine
what are ADRs of levothyroxine Warfarin potentiated --> increased metabolism of clotting factors. Sympathomimetic --> potentiate cardiac effects
What 3 drugs will increase metabolism of levothyroxine phenytoin, riampin, carbemazepine
What thyroid drug is rarely used due to $$$ and shorter duration liothyronine T3, which has same interactions as T4
how do we treat myxedema quick admin of IV T3/T4, then oral. concurrent corticosteroids.
name 2 drugs to treat hyperthyroidism PTU propylthiouracil, methimazole
do drugs that tx hyperthyroidism destroy pre-formed thyroid? no, these drugs only affect the synthesis of NEW hormone
propylthiouracil MOA blocks several steps in the oxidation of iodide and coupling of tyrosine. ALSO inhibits peroxidase enzymes. ALSO decreases peripheral conversion of T4-->T3
propylthiouracil ADRs rare agranulocytosis (CBC/diff). dose related hypothyroidsim
methimazole MOA same as propylthiouracil (shuts down hormone synthesis) EXCEPT no action in peripheral conversion of T4-->T3
Created by: lorrelaws