DRUGS OF THE ENDOCRINE

SYSTEM
Endocrine System
 Major elements are the hypothalamus, pituitary
gland, thyroid gland, parathyroid glands,
pancreas, adrenal glands, ovaries, and testes
Other tissues that produces hormones:

 The gastrointestinal mucosa produces hormones

that are important in the digestive process (e.g.
gastrin, enterogastrone, secretin,
cholecystokinin)
 The kidneys produce erythropoietin, a hormone

that stimulates the bone marrow to produce

red blood cells
 White blood cells produce cytokines that
function as messengers among leukocytes in
inflammatory and immune processes
 Many body tissues produce prostaglandins and
leukotrienes which have a variety of
physiologic effects
 Neoplasm also may produce hormones
Ex: lung tumors may produce corticotropin
(adrenocorticotropic hormone (ACTH), antidiuretic
hormone, or parathyroid hormone
: kidney tumors may produce parathyroid
hormone
Endocrine System- Nervous System
Interactions
 Work in harmony to integrate and regulate
body functions
 Endocrine system regulates slow metabolic

activities by secreting hormones that control

cellular metabolism, transport of substances
across cell membranes, and other functions (e.g.
reproduction, growth and development,
secretion)
 The hypothalamus secretes hormones releasing
and inhibitory factors, that regulate functions
of the anterior pituitary. The anterior pituitary
in turn, secretes hormones that act on target
tissues, usually to stimulate production of other
hormones (hypothalamic-pituitary-
adrenocortical (HPA) axis)
 It functions by a negative feedback system, in
which hormone secretion is stimulated when
hormones are needed and inhibited when they
are not needed
Hormones
 Are chemical substances synthesized from
amino acids and cholesterol that act on body
tissues and organs and affect cellular activity
General Characteristics of Hormones

 Although hormones circulating in the

bloodstream reach essentially all body cells,
some (e.g. growth hormone, thyroid hormone)
affect almost all cells, whereas others affect
specific “target” tissues (e.g. corticotropin
stimulates the adrenal cortex)
 One hormone can affect different tissues (e.g.
ovarian estrogen can act on ovarian follicles to
promote their maturation, on the endometrial
lining of the uterus to stimulate its growth and
cyclic changes, on breast tissue to stimulate
growth of milk ducts, and on the hypothalamic-
pituitary system to regulate its own secretion)
 Several hormones can affect a single tissue or
function (e.g. catecholamines, glucagon,
secretin and prolactin regulate lipolysis –
release of fatty acids from adipose tissue)
 Several hormones are secreted in cyclic
patterns (e.g. ACTH, cortisol and growth
hormone are secreted in circadian cycles;
estrogen and progestin secretion are related to
the 28-day menstrual cycle
Categories of Hormone:
 Protein-derived hormones (amines, amino acid,
peptides and polypeptides)
 Steroids hormones (adrenal gland and gonads)
Second-Messenger System
 Cyclic adenosine monophosphate (cAMP)
 Calcium-calmodulin

 Phospholipid products
Second-Messenger System (cAMP)
 cAMP is the second-messenger for many
hormones including corticotropin,
catecholamines, glucagon, thyroid-stimulating
hormone, follicle-stimulating hormone,
luteinizing hormone, parathyroid hormone,
secretin and antidiuretic hormone
 The amount of intracellular cAMP is increased
by hormones that activate adenyl cyclase (e.g.
the pituitary hormones, calcitonin, glucagon,
parathyroid hormone) and is decreased by
hormones that inactivate adenyl cyclase (e.g.
angiotensin, somatostatin)
 Cyclic AMP is inactivated by

phosphodiesterase enzymes
Second-Messenger System (Calcium)

 Calcium is the second messenger for

angiotensin II, is strong vasoconstrictor that
participates in control of arterial blood
pressure, and for gonadotropin-releasing
hormone
 Calcium binds with an intracellular regulatory

protein called calmodulin

 The calcium-calmodulin complex activates
protein kinases, which then regulate contractile
structures of the cell, cell membrane
permeability, and intracellular enzyme activity.
 Specific effects include contraction of smooth

muscle, changes in the secretions produced by

secreting cells, and changes in ciliary action in
the lungs
Second-Messenger System
(Phospholipid)
 Phospholipid products are mainly involved with
local hormones
 Phospholipids are major components of the cell
membrane portion of all body cells
 Some local hormones activate cell membrane
receptors and transform them into phospholipase
C, an enzyme that cause some of phospholipids in
cell membranes to split into smaller molecules (e.g.
inositol, triphosphate and diacylglycerol)
 Inositol triphosphate mobilizes intracellular
calcium ions and the calcium then fulfill their
functions as second messengers
 Diacylglycerol activates protein kinase
C..enzyme important in cell reproduction
Glandular Hypofunction
 A congenital defect may result in the absence
of an endocrine gland, the presence of an
abnormally developed gland, or the absence
of an enzyme required for glandular synthesis
of its specific hormone
 The endocrine gland may atrophy and become
less able to produce its hormone because of
aging, drug therapy, disease, or unknown
reasons
 The endocrine gland may be damaged or
destroyed by impaired blood flow, infection or
inflammation, autoimmune disorders or
neoplasm
 The endocrine gland may produce adequate
hormone, but the hormone may not be able to
function normally because the receptor defects
(not enough receptors or the receptors present
are unable to bind with the hormone)
 Even if there is adequate hormone and
adequate binding to receptors, intracellular
metabolic processes may not respond
appropriately
Glandular Hyperfunction
 Excessive amounts of hormone may occur from
excessive stimulation and enlargement of the
endocrine gland, from a hormone-producing
tumor of the gland, or from a hormone-
producing tumor of nonendocrine tissues (lung
tumors)
Use of Hormonal Drugs
 Hormones are given for physiologic or
pharmacologic effects and are more often
given for disorders resulting from endocrine
gland hypofunction than for those related to
hyperfunction
 Physiologic use involves giving small doses as a
replacement or substitute for the amount
secreted by a normally functioning endocrine
gland
Ex:
Insulin administration in DM and adrenal
corticosteroid administration in Addison’s disease
 Pharmacologic use involves relatively large doses
for effects greater than physiologic effects
Ex:
Adrenal corticosteroids used for anti-inflammatory
effects in endocrine and non-endocrine disorders
Pituitary Gland (Hypophysis)
 Anterior pituitary (adenohypophysis)
- master gland (it secrete hormones that
stimulate the release of other hormones from
target glands, including thyroid, parathyroid,
adrenals and gonads
 Posterior pituitary (neurohypophysis)

- secretes neurohormones – antidiuretic hormone,

or vasopressin (hormone that raises BP) and
oxytocin
Anterior Pituitary Drugs
 The protein hormones produced in the anterior
pituitary gland regulate growth, development,
and sexual characteristics by stimulating the
actions of other endocrine glands
 Includes:

- adrenocorticotropics, which include

corticotropin, corticotropin repository,
corticotropin zinc hydroxide, and eosyntropin
 - somatrem and somatropin, growth hormones
- gonadotropics, which include chorionic
gonadotropin and menotropins
- thyrotropics, which include thyroid-stimulating
hormone, thyrotropin, and prottrelin
Pharmacokinetics
 Are not given orally because they are
destroyed in the GI tract. Can be administered
topically, but most require injection
Absorption, Distribution and
Metabolism
 Natural hormones are absorbed, distributed,
and metabolized rapidly while analogues are
more slowly
 Anterior pituitary drugs are metabolized at the
receptor site and in the liver and kidneys
 Hormones are excreted primarily in urine
Pharmacodynamics
 Anterior pituitary drugs exert a profound
effect on the body’s growth and development.
The hypothalamus controls secretions of the
pituitary gland. In turn, the pituitary gland
secretes hormones that regulate secretions or
functions of other glands
Pharmacodynamics

 The concentration of hormones in the blood

helps determine hormone production rate.
Increased hormone levels inhibit hormone
production; decreased levels raise production
and secretion
Pharmacotherapeutics
 Used for:
- corticotropin and cosyntropin are used
diagnostically to differentiate between primary
and secondary failure of the adrenal cortex
- corticotropin is also used to treat adrenal
insufficiency
- somatrem is used to treat growth hormone
deficiency
Anterior Pituitary Hormones
 Thyroid-stimulating hormone (TSH)
 Adrenocorticotropic hormone (ACTH)

 Gonadotropin [follicle stimulating hormone

(FSH) and leutenizing hormone (LH)]

* They control synthesis and release of hormones
from the thyroid, adrenals and ovaries
Anterior Pituitary Hormone
 Growth hormone (GH)
 Prolactin

 Melanocyte stimulating hormone (MSH)

Thyroid Stimulating Hormone
 Thyroxine (T4)
 Triiodothyronine (T3)

- hypersecretion can cause hyperthyroidism and

thyroid enlargement
- hyposecretion can cause hypothyroidism
Adrenocorticotropic Hormone
 Stimulates the release of glucorticoids
(cortisol), mineralocorticoids (aldosterone) and
androgen from the adrenal cortex
* More ACTH is secreted in the morning than in
the evening
Gonadotropic Hormone
FSH promotes the maturation of follicles on the
ovaries and initiates sperm production in the
testes
Prolactin stimulates milk formation in the
glandular breast tissue after childbirth
Growth Hormone
 Acts on all body tissues, particularly the bones
and skeletal muscles
Posterior Pituitary Drugs
 Are synthesized in the hypothalamus and
stored in the posterior pituitary, which, in turn,
secretes the hormones into the blood. These
drugs include:
- all forms of antidiuretic hormone (ADH), such
as desmopressin acetate and vasopressin
- the oxytocic drug oxytocin
Pharmacokinetics
 May be given by injection or intranasal spray
Absorption, Distribution and
Metabolism
 Natural hormones, oxytocic drugs are usually
absorbed, distributed, and metabolized
rapidly
 Parenterally administered oxytocin is absorbed
rapidly; however, when it’s administered
intranasally, absorption is erratic
Pharmacodynamics
 Neural control, affects:
- smooth muscle contraction in the uterus,
bladder, and GI tract
- fluid balance through kidney reabsorption of
water
- blood pressure through stimulation of the
arterial wall muscles
 ADH increases cyclic adenosine
monophosphate (cAMP), which increases the
permeability of the tubular epithelium in the
kidneys, promoting reabsorption of water. High
dosages of ADH stimulate contraction of blood
vessels, increasing the blood pressure
 Desmopressin reduces diuresis and promotes

clotting by increasing the plasma level of

factor VIII (antihemophilic factor)
 In pregnant women, oxytocin may stimulate
uterine contractions by increasing the
permeability of uterine cell membranes to
sodium ions. It also can stimulate lactation
through its effect on mammary glands
Pharmacotherapeutics
 ADH is prescribed for hormone replacement
therapy in patients with neurogenic diabetes
insipidus (an excessive loss of urine caused by
a brain lesion or injury that interferes with ADH
synthesis or release. However, it doesn’t
effectively treat nephrogenic diabetes insipidus
(caused by renal tubular resistance to ADH)
ADH Treatment
 Desmopressin is the drug of choice for chronic
ADH deficiency and is administered
intranasally. It’s also indicated for primary
nocturnal enuresis. Desmopressin has a long
duration of action and relatively few adverse
effects
 Short-term ADH treatment is indicated for
patients with transient diabetes insipidus after
head injury or surgery; therapy may be
lifelong for patients with idiopathic hormone
deficiencies. Used for short-term therapy,
vasopressin elevates blood pressure in patients
with hypotension caused by lack of vascular
tone. It also relieves postoperative gaseous
distention
Oxytocics
 Used to:
- induce labor and complete incomplete
abortions
- treat preeclampsia, eclampsia and premature
rupture of membranes
- control bleeding and uterine relaxation after
delivery
- hasten uterine shrinking after delivery
- stimulate lactation
Posterior Pituitary Gland
ADH
– increases reabsorption of water in the renal
tubules, returning it in the systemic circulation
Oxytocin
- stimulates contraction of the smooth muscles of
the uterus
Thyroid Gland
 Thyroxine and triiodothyronine
- stimulation of these hormones results in an
increase in cardiac output, oxygen
consumption, carbohydrate use, protein
synthesis and breakdown of fat
- affects body heat regulation and menstrual
cycle
Thyroid and Antithyroid Drugs
 Function to correct thyroid hormone deficiency
(hypothyroidism) and thyroid hormone excess
(hyperthyroidism)
Thyroid drugs
 Can be natural or synthetic hormones and may
contain triiodothyronine, thyroxine or both
Pharmacokinetics
 Are absorbed variably from the GI tract,
distributed in plasma, and bound to serum
proteins
Metabolism and Excretion
 Thyroid drugs are metabolized through
deiodination, primarily in the liver, and
excreted unchanged in stool
Pharmacodynamics
 An increased metabolic rate in body tissues.
Thyroid hormone affect protein and
carbohydrate metabolism and stimulate protein
synthesis.
 They promote gluconeogenesis (the formation

of glucose from free fatty acids and proteins)

and increase the use of glycogen stores
 Thyroid hormones increase heart rate and
cardiac output (the amount of blood pumped
by the heart each minute)
 Increase the heart’s sensitivity to
catecholamines and increase the number of
beta-adrenergic receptors in the heart
(stimulation of beta receptors in the heart
increases heart rate and contractility)
 May increase blood flow to the kidneys and
increase the glomerular filtration rate (the
amount of plasma filtered through the kidney
each minute) in hypothyroid patients, producing
diuresis
Pharmacotherapeutics
 To treat the many forms of hypothyroidism
 with antithyroid drugs to prevent goiter

formation (an enlarged thyroid gland) and

hypothyroidism
 To differentiate between primary and

secondary hypothyroidism during diagnostic

testing
 To treat papillary or follicular thyroid

carcinoma
Antithyroid drugs
 Used for patients with hyperthyroidism include:
- thiomides, which include propylthiouracil and
methimazole
- iodides, which include stable iodine and
radioactive iodine
Pharmacokinetics
 Thioamides and iodides are absorbed through
the GI tract, concentrated in the thyroid,
metabolized by conjugation, and excreted in
urine
Pharmacodynamics
 Drugs used to treat hyperthyroidism work in
different ways
 Thioamides block iodine’s ability to combine

with tyrosine, thereby preventing thyroid

hormone synthesis
 Stable iodine inhibits hormone synthesis through

the Wolff-Chalkoff effect, in which excess

iodine decreases the formation and release of
thyroid hormone
 Radioactive iodine reduces hormone secretion
by destroying thyroid tissue through induction
of acute radiation thyroiditis and chronic
gradual thyroid atrophy. Acute radiation
thyroiditis usually occurs 3 to 10 days after
administering radioactive iodine. Chronic
thyroid atrophy may take several years to
appear
Pharmacotherapeutics
 Used to treat hyperthyroidism, especially in the
form of grave’s disease (hyperthyroidism
caused by autoimmunity)
 Propylthiouracil
- lowers serum T3 levels faster than
methimazole, is usually used for rapid movement
of severe hyperthyroidism
- preferred for pregnant women, reduces
transfer across the placental barrier and it
doesn’t cause aplasta cutis (a severe skin
disorder) in the fetus
 Propylthiouracil and methimazole appear in
breast milk

 Methimazole blocks thyroid hormone for a

longer time, administration once per day for
mild to moderate hyperthyroidism for 12 to 24
months
Parathyroid Gland
 Parathormone
- Regulates calcium levels in the blood
Adrenal Glands
 Adrenal medulla releases catecholamines
(epinephrine and norepinephrine)
 Adrenal cortex releases corticosteroids
Pancreas
 Exocrine – digestive enzymes
 Endocrine - insulin
Drugs for Pituitary, Thyroid,
Parathyroid and Adrenal
Disorders
The Hypothalamus and Pituitary Gland

Hypothalamus
Secretes releasing hormone

Pituitary Gland
Secretes stimulating hormone

To specific glands
Specific hormone
Indications for Hormone Pharmacotherapy

 Replacement therapy
 Cancer chemotherapy to shrink size of

hormone-sensitive tumors
 Exaggerated response ex. Hydrocortisone to
suppress inflammation
 Anti-hormones (to block actions of endogenous

hormones ex.propylthiouracil to block the

effects of an overactive thyroid gland)
Pituitary Gland (Anterior Lobe)
 Growth hormone, which stimulates growth in
tissue and bone
 Thyroid-stimulating hormone, which acts on the

thyroid gland
 Adrenocorticotrophic hormone, which stimulates

the adrenal gland

 Gonadotrophins (FSH, LH), affects the ovaries
 Pharmacotherapy with Pituitary
Hormones

Growth Hormone or Somatotropin

 Cannot be given orally, they are inactivated
by gastrointestinal enzymes
 Must be administered before the epiphyses
are fused
 Prolonged GH therapy can antagonize insulin

secretion and eventually cause DM

 Pharmacotherapy with Pituitary
Hormones

Growth Hormone or Somatotropin

 Stimulates the growth and metabolism of
nearly every cell in the body
 Short stature or dwarfism (deficiency)
characterized by significantly decreased
physical height compared with the norm of
specific age group
 Pharmacotherapy with Pituitary
Hormones

Growth Hormone or Somatotropin

Somatrem (Protropin) and Somatropin
(Humantrope) used in children with growth
failure
It is contraindicated in pediatric clients who
have growth deficiency due to Prader-Willi
syndrome and are severely obese or who
have severe respiratory impairment
 Pharmacotherapy with Pituitary
Hormones

Growth Hormone or Somatotropin

Before 2003 GH therapy was approved for
treating deficiencies, however, today GH is
used for children with stature even with
normal GH
 Pharmacotherapy with Pituitary
Hormones

Growth Hormone or Somatotropin

 Acromegaly (excess); Gigantism
 Octreotide (Sandostatin) is a synthetic GH

antagonist structurally related to GH-

inhibiting hormone (somatostatin)
 Pegvisomant (Somavert), a growth hormone-

receptor antagonist
 Pharmacotherapy with Pituitary
Hormones

Thyroid-Stimulating Hormone
Stimulates release of thyroxine (T4) and
triiodothyronine (T3)
Thyrotropin (thytropar), a purified extract of
TSH, used as a diagnostic agent to
differentiate between primary and secondary
hypothyroidism
 Pharmacotherapy with Pituitary
Hormones

Adrenocorticotropic Hormone
Stimulates the release of glucocorticoids
(cortisol), mineralocorticoids (aldosterone) and
androgen from the adrenal cortex
ACTH and cortisol is higher in the morning
(diurnal) and decreases throughout the day
Stress, surgery, trauma can increase further the
ACTH and cortisol
 Pharmacotherapy with Pituitary
Hormones

Adrenocorticoptropic Hormone
Corticotropin (Acthar) is used to diagnose
adrenal gland disorders, to treat adrenal
gland insufficiency, and as an anti-
inflammatory drug in treatment of allergic
response
“Zinc is added to some formulations to slow the
absorption rate”
Posterior Lobe (Neurohypophysis)
 Secretes antidiuretic hormone (promotes water
reabsorption from the renal tubules to maintain
water balance in the body fluids) and oxytocin
 Diabetes insipidus (ADH deficiency) can lead
to severe fluid volume deficit and electrolytes
imbalances
 ADH preparations vasopressin (Pitressin) and

desmopressin acetate (DDAVP) can be

administered intranasally or by injection
Thyroid Gland
 The functions of T3 and T4 are to regulate
protein synthesis and enzyme activity and to
stimulate mitochondrial oxidation
 Hypothyroidism
 A decrease in thyroid hormone secretion, can
have either a primary cause (thyroid gland
disorder) and secondary cause (lack of TSH
secretion)
 Myxedema is severe hypothyroidism in the adult;

symptoms include lethargy, apathy, memory

impairment, emotional changes, slow speech,
deep coarse voice, edema of eyelids and face,
thick dry skin, cold intolerance, slow pulse,
constipation, weight gain, and abnormal menses
Hypothyroidism
 Cretinism is congenital hypothyroidism
 Levothyronine sodium (Levothroid, Synthroid) –

increases the levels of T3 and T4; used to treat

simple goiter and chronic lymphocytic
(hashimoto) thyroiditis
 Hyperthyroidism
 Is an increase in circulating T4 and T3 levels,
which results from an overactive thyroid gland or
excessive output of thyroid hormones from one or
more thyroid nodules
 Graves disease or thyrotoxicosis, common type of

hyperthyroidism caused by hyperfunction of the

thyroid gland; characterized by rapid pulse,
palpitations, excessive perspiration, heat
intolerance, nervousness, irritability, exopthalmos
and weight loss
Hyperthyroidism
 Thiourea derivatives drug of choice to
decrease thyroid hormones by inhibiting
thyroid secretion
 Propylthiouracil (PTU) and methimazole
(tapazole)
Lugol’s solution used to suppress thyroid function
for clients who have undergone subtotal
thyroidectomy
Parathyroid Glands
 Secretes parathyroid hormone (PTH), which
regulates calcium levels in the blood.
 PTH promotes calcium absorption from the GI

tract, promote reabsorption of calcium from the

renal tubules, and activate vitamin D
 Calcitriol is a vitamin D analogue that

promotes calcium absorption from the GI tract

and secretion of calcium from the bone to the
bloodstream
Adrenal Glands
Adrenal cortex (Corticosteroids)
- glucocorticoids (cortisol)
- mineralocorticoids (aldosterone)
Corticosteroids
 promote sodium retention and potassium
excretion
Glucocorticoids
 Affect CHO, CHON and fat metabolism and
muscle and blood cell activity
 Cortisol is the main glucocorticoids, has

antiinflammatory, antiallergy, and antistress

effects
Glucocorticoids
 Prednisone (inexpensive glucocorticoids) is
readily absorbed from the GI tract; excreted
primarily in the urine
- are to suppress an acute inflammatory process
and for immunosuppression. It prevents cell-
mediated immune reactions
Glucocorticoid Inhibitors
 Antifungal drug ketoconazole (nizoral) and
antineoplastic hormone antagonists mitotane
and aminoglutethimide inhibit glucocorticoid
synthesis
Ketoconazole (Nizoral)
 Ketoconazole is effective in treating clients with
cushing syndrome and is useful as an adjunct to
surgery or radiation
 High doses can induce fatal ventricular
dysrrhythmias
Mineralocorticoids
 Secrete aldosterone (controlled by the renin-
angiotensin system)
 These hormones maintain fluid balance by

promoting the reabsorption of sodium from the

renal tubules
 Fludrocortisone (florinef) is an oral

mineralocorticoid
Estrogens
 Estrogens mimic the physiologic effects of
naturally occurring female sex hormones
 Are used to correct estrogen-deficient states

and along with hormonal contraceptives,

prevent pregnancy
Types:
 Natural products, such as conjugated as
estrogenic substances, estradiol, and
estropipate
 Synthetic estrogens such as esterified estrogens,
estradiol cyptonate, estradiol valerate, and
ethinyl estradiol
Pharmacokinetics
 Are well absorbed and distributed throughout
the body. Metabolism occurs in the liver, and
the metabolites are excreted primarily by the
kidneys
Pharmacodynamics
 Increase synthesis of deoxyribonucleic acid,
ribonucleic acid, and protein in estrogen-
responsive tissues in the female breast, urinary
tract, and genital organs
Pharmacotherapeutics
 Prescribed:
- primarily for hormone replacement therapy in
postmenopausal women to relieve symptoms
caused by loss of ovarian function
- less commonly for hormonal replacement
therapy in primary ovarian failure or female
hypogonadism, for prevention and treatment of
osteoporosis in postmenopausal women, and in
patients who have undergone surgical castration
- palliatively to treat advanced, inoperable
breast cancer in postmenopausal women and
prostate cancer in men
Let’s review
Medication Classification: Insulin
 Promotes cellular uptake of glucose; converts
glucose into glycogen; moves potassium into
cells
 Only regular insulin may be administered
intravenously
Medication Classification: Oral
Hypoglycemics- Sulfonylureas
 Promote insulin release from the pancreas
 Example:

1st generation: tolbutamide

2nd generation: glipizide
Medication Classification: Oral
Hypoglycemics- Meglitinides
 Promote insulin release from the pancreas
 Example: repaglitinide
Medication Classification: Oral
Hypoglycemics - Biguanides
 Reduce the production of glucose within the
liver through suppression of gluconeogenesis;
increase muscles’ glucose uptake and use
 Used to treat polycystic ovary syndrome
Medication Classification: Oral
Hypoglycemics- Thiazolidinediones
“Glitazones”
 Increase cellular response to insulin by
decreasing insulin resistance
Medication Classification: Oral
Glycemics- Alpha Glucosidase
 Slows carbohydrate absorption and digestion
 Example: Acarbose
Medication Classification: For insulin
overdose
 Glucagon
- Increasing the breakdown of glycogen into
glucose
- Decreasing glycogen synthesis (decrease
storage of glucose)
- Stimulating synthesis of glucose
Medication Classification: Thyroid
Hormones
 Are a synthetic form of thyronine and that
increase metabolic rate, protein synthesis,
cardiac output, renal perfusion, oxygen use,
body temperature, blood volume, and growth
processes
 Example: Levothyroxine

 Used for the emergency treatment of

myxedema coma (IV route)

 Contraindicated to MI
Medication Classification: Antithyroid
Medications
 Block the synthesis of thyroid hormones
 Prevent the oxidation of iodide

 Block conversion of T4 to T3

 Example: propylthiouracil (PTU)

 Medication Classification: Thyroid-
Radioactive Iodine
 Destroys thyroid cells
 At high doses – hyperthyroidism and thyroid

cancer
 At low doses – thyroid function studies
(visualization of the degree of iodine uptake by
the thyroid gland is helpful in the diagnosis of
thyroid disorders)
 Radioactivity precautions:

- encourage to void frequently to avoid irradiation

of gonads
Medication Classification: Thyroid-
Radioactive Iodine
- limit contact with client to one half
hour/day/person
- encourage the client to increase fluid intake
- instruct the client to dispose of body wastes
per protocol
- instruct the client to avoid coughing and
expectation
Medication Classification: Thyroid-
Nonradioactive Iodine
 Creates high levels of iodide that will reduce
iodine uptake, inhibit thyroid hormone
production, and block the release of thyroid
hormones into the bloodstream
 Used for dev’t of eithyroid state and reduction

of thyroid gland size prior to thyroid removal

surgery
 Example: lugol’s solution
Medication Classification: Anterior
Pituitary Hormones/ Growth Hormones
 Stimulate overall growth, the production of
protein, and decrease use of glucose
 Example: Somatrem
Medication Classification: Posterior
Pituitary Hormones/ Antidiuretic
Hormone
 Promotes absorption of water within the
kidneys; causes vasoconstriction due to the
contraction of vascular smooth muscle
 Example: vasopressin
Nobody should seek his own good. But the good of
others. Corinthians 10: 24