Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Regulation:
Regulation
of thyroid function
Synthesis
of thyroid hormones
MIT: monoiodotyrosine
Thyroid hormones
triiodothyronine (T3)
DIT: diiodotyrosine
DIT+DITT4
TH SYNTHESIS
Thyroid
MECHANISM
OF ACTIONS
OF THYROID HORMONES
LevothyroxineSynthetic T4
LiothyronineSynthetic T3
LiotrixCombination of synthetic T4 and T3
Natural Thyroid HormonesThyroid hormones derived from pigs, contains T4 and T3
Armour Thyroid
Because thyroid hormones serve to increase heart rate, T4, the inactive form, is
typically administered to older patients who have an increased risk for heart attack
on account of their age. Synthetic T3 is reserved for younger patients, who do not
have a history of heart problems and individuals non-responsive to T4 treatment.
Some men are inefficient in the conversion of T4 to T3, making combination drugs
like Litrix and Armour Thyroid ideal treatment options.
Pharmacological
effect
see physiological effect
Clinical
use
reactions
Antithyroid drugs
Drugs
Class
Representative
propylthiouracil
Thioamides
methylthiouracil
methimazole
carbimazole
Iodides
Radioactive iodine
-adrenoceptor blockers
KI, NaI
131I
propranolol
. Thioamides
Structure
The thiocarbamide
group is essential for
antithyroid activity
Pharmacological action
Inhibition of the synthesis of T3 & T4
Mechanism
All thioamides inhibit peroxidase-catalyzing reactions
Iodine organification
First choice for
thyroid crisis
Iodotyrosines condensation
Propylthiouracil also inhibit T4 converting to T3
Characteristics
Result appears slowly: in 3-4 w hyperthyroid ameliorated,
and in 2-3 months BMR normalized;
Long-term use leads to thyroid hyperplasia
Methimazole is 10 times as potent as propylthiouracil
Clinical use
treatment of hyperthyroid
1. Mild hyperthyroid and those surgery & 131I
not permitted;
2. Operation preparation;
3. Thyroid crisis (comprehensive therapy).
Adverse reactions
1. Long-term use leads to thyroid hyperplasia;
2. Pruritic maculopapular rash is the most common
adverse raaction
3. The severe adverse reaction is agranulocytosis
Clinical use
Ministrant treatment of hyperthyroid
1. Operation preparation;
2. Thyroid crisis.
Adverse reactions
1. Acneiform rash (similar to that of bromism);
2. Swollen salivary glands, mucous membrane ulcerations, and etc.