Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Synthetic
thyroid
hormones
Levothyroxine (T4)
(others:
Liothyronine
(T3) & Liotrix)
Anti-thyroid drugs
Thioamides
*All 3 cross the
placenta;
though PTU
crosses it the
least
Anion
inhibitors
*These are less
important
know AE
Iodine &
Iodides
*Wolf-Chaikoff
effect: large
doses of iodine
(-) further
synthesis of
iodine
Radioactive
Iodine
*Outpatient tx,
permanent
cure, but slow
response &
80% become
hypothyroid
Propythiouracil
(PTU)
Methimazole
Carbimazole
*Methimazole is longer
acting & more potent thus
is the DOC for
hypothyroidism
Perchlorate (ClO4-)
Pertechnetate
(TcO4-)
Thiocyanate (SCN-)
Lugols Iodine (I2 +
KI)
Na Iodide
K Iodide
Iodinated contrast
media: Diatrizoate
Use: Hypothyroidism
- Congenital: Cretinism
- Childhood hypothyroidism
- Adult hypothyroidism: Hashimotos thyroiditis
- Myxedema coma
o Occurs in elderly during the winter
o Medical emergency
o Hypothermia, resp. distress, loss of
consciousness
o May also try IV Liothyronine
Use: Hypothyroidism
- Graves disease: DOC is Methimazole
Toxicity:
- Maculopapular rash
- Agranulocytosis (<500)
- Hepatitis (PTU)
MOA: (-) thyroid peroxidase No iodine oxidation/ no
MIT/DIT coupling
*PTU can also (-) peripheral conversion of T4 to T3
MOA: competitive (-) Na+/Iodide transporter (-) uptake of
iodide
AE: aplastic anemia (thus no longer used)
Use: Amiodarone-induced thyrotoxicosis
MOA: (-) hormone release & dec. vascularity, size, &
fragility of a hyperplastic gland
Use: pre-operative preparation
Thyroid escape: gland escapes from the iodide block in 2-8
weeks
Use: Diagnosis of hypothyroidism
Iohexol
131
I (oral)
123
Adrenorecepto
r blocking
agents
Metoprolol
Propanolol
Atenolol