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Pharmacology > Thyroid Drugs > Flashcards

Thyroid Drugs Flashcards

1
Q

Thyroid hormone preparations

A

Levothyroxine
Liothyronine
Liotrix
Thyroid desiccated

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2
Q

Thyroid hormone preparations - MoA

A

Binds to receptors causing increased gene transcription that leads to increased levels of proteins for growth, development, heat production.

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3
Q

Thyroid hormone preparations - Contraindications

A

Lithium: inhibit release of thyroid hormones

Amiodarone: cause either hyper/hypothyroidsm

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4
Q

Levothyroxine - Classification

A

Synthetic T4

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5
Q

Levothyroxine - MoA

A

Converted to T3 in tissues, effects from both thyroid hormones

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6
Q

Levothyroxine - Clinical use

A

Hypothyroidism (DOC).
TSH suppression in thyroid nodules, diffuse goiters, thyroid cancer (DOC).
Myxedema coma (IV)

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7
Q

Levothyroxine - Adverse effects

A

Hyperthyroidism in high doses

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8
Q

Levothyroxine - Interactions

A

Aluminum hydroxide, Ca2+-supplements, cholestyramine, ferrous sulfate, sucralfate decrease absorption.

Coffee, soy, dietary fiber: reduced absorption

Increased TSH:levothyroxine not sufficinent.

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9
Q

Liothyronine - Classification

A

Synthetic T3

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10
Q

Liothyronine - MoA

A

Does not increase plasma T4 –> difficult to monitor response to treatment.

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11
Q

Liotrix - Classification

A

T4+T3 (4:1)

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12
Q

Thyroid desiccated - Classifiaction

A

Natural pig T4+T3

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13
Q

Antithyroid agents

A 
Thioamide drugs:
Methimazole
Propylthiouracil
β-adrenoceptor antagonists
Iodide salts 
RAI
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14
Q

Antithyroid agents - Clinical use

A

Hyperthyroidism

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15
Q

Thioamide drugs - MoA

A

Inhibit synthesis of thyroid hormones by inhibition thyroperoxidase-catalysed steps.

Inhibition of hormone synthesis and depletion of glandular stores.

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16
Q

Thioamide drugs - Clinical use

A

Graves disease: induce remission or control symptoms before surgery/RAI.

17
Q

When do you need to check for agranulocytosis in the case of thioamide drugs?

A

In case of fever, malaise, sore throat, flulike-symptoms

18
Q

Thioamide drugs - Adverse effects

A

Relapse (esp pt with thyroid-stimulating antibodies)
Pruritic maculopapular rash, arthralgia, fever.
Lupus erythematosus-like syndrome, hepatitis, GI distress.
Transient leukopenia, agranulocytosis.
Liver injury, fatal liver failure
Cross-sensitivity

19
Q

Which thioamide drug is contraindicated during pregnancy because of birth defects?

A

Methimazole

20
Q

Methimazole - Adverse effects

A

Birth defects

21
Q

Propylthiouracil - MoA

A

Also inhibit conversion of T4 –>T3 in peripheral tissue.

22
Q

Propylthiouracil - Clinical use

A

DOC just before and during 1st trimester

23
Q

Propylthiouracil - Adverse effects

A

Increased incidence of liver failure

24
Q

β-adrenoceptor antagonists

A

Propanolol

25
Q

β-adrenoceptor antagonists - MoA

A

inhibit conversion of T4 –>T3

Reduce cardiovascular stimulation ass with hyperthyroidism (arrhythmias, palpitations, tachycardia)

26
Q

β-adrenoceptor antagonists - Clinical use

A 
Severe thyrotoxicosis (thyroid storm)
Symptomatic (control cardiovascular symptoms) in hyperthyroidism before surgery/RAI treatment.
27
Q

Iodide salts

A

Potassium iodine

Sodium iodine

28
Q

Iodide salts - MoA

A

Inhibit release of thyroid hormones

29
Q

Iodide salts - Clinical use

A

After RAI to inhibit radioactive thyroid hormone release.

30
Q

Iodide salts - Adverse effects

A

Skin rashes, hypersensitivity reactions, salivary gland swelling, metallic taste, sore gums, GI discomfort

31
Q

Iodide salts - Contraindications

A

Should not be used before RAI treatment because nonradioactive iodide compete with I for uptake by the thyroid gland.

Pregnancy

32
Q

Thyrotropin alfa - Classification

A

Recombinant human thyrotropin

33
Q

Thyrotropin alfa - Clinical use

A

Increase thyroid gland uptake of RAI in diagnosis and treatment of thyroid conditions

34
Q

What happens if you start Levothyroxine treatment with too high dose?

A

Cardiovascular stress

35
Q

Sodium iodine - Contraindication

A

Pretreatment with thioamide drugs and pregnancy

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