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Flashcards in (Anti-) Thyroid Deck (34):
1

concept: how do thyroid hormones increased BMR

increases BMR via Na/K ATPase = increases resp rate, increases temperature, increases O2 consumption

2

concept: effect of thyroid hormones on catecholamines

increases sympa activit = increase Co and HR

3

concept: effet of thyroid on brain

development

4

Where do you find 5'iodinase (not relaly important for this i dont think)

peripheral tissue
liver
kidney
pituitary gland
brain
brown fat

5

describe receptors fo TRH -- TSH -- T3/T4

TRH - IP3
TSH - cAMP
T3/T4 - nuclear

(Words get bigger as you go furhter down chain)

6

What is levothyroxine

longet t1/2 T4
LEVO has four letters - thyroxine

7

What is Liothyronine

shorter t1/2 T3
LIO has three letters - thyronine

8

A/se of levothyroxine and liothyronine

tremors, tachycardia, arrhtymias, heat intolerace ie hyperthyroidism

9

effects of rifampin, phenobarbital and phenytoin on levels of T3 and T4

induce P450 blleeehhh so increased metabolism so less thyroid hormone

10

I say Queen Anne

you say laterla third eyeborw loss

11

Name the Thioamides

Propylthiouracil
methimazole

12

~*~MOA of propylthiouracil and methimazole

block idination of thyroglobulin and inhibit coupling reaction = reduced T3 and T4

inhibit thyroperoxidase so decreased new T3 adn new T4 but not preformed.

13

Preferred drug in thyroid storm and why please

propylthiouracil
bc

1) inhibits 5-deiodinase -- decreased conversion from T4 to T3

(methimazole does not do this)

14

~*~A/se of thiamide, propylthiouracil

propylthiouracil = rash, agranulocytosis, aplastic anemia, hepatotoxicity, vasculitis

15

~*~A/se of thiamide, metimazole

less severe, and therefore more preferred in clinical setting
POSSIBLE TERATOGEN

16

WOLFF CHAIKOFF!!

iodide at high levels inhibit organification and release = lower levels, but this wanes at 10-14 days and therefore is not used for long term treatment

17

Used of Iodine and Iodide salts

decreases vascularity and size of gland -- used before surgery before excision

and tyrotoxicosis cirisis with propylthiouracil and beta blockers

18

Three drugs used in thyrotoxic crissi

propylthiouracil
Iodine/Iodide salts
beta blockers

19

Describe the prepartions available for iodine and iodide salts

1) lugol solution - iodine and potassium iodide
2) saturated solution of potassium iodide only

20

THyroid storm again. the lecture just keeps adding drugs

propylthiouracil
iodine/iodide salts
beta blcokers - nadolol, atenolol

21

MOA propanolol

non specific bb
**prevents conversion of T4 to T3

22

MOA esmolol

short acting BB
control intraoperative thyroid storm

23

DOC at intraoperative thyroid storm

esmolol

24

DOC at thyroid storm in patients with asthma

diltiazem - calcium channel blocker

SHARK flashback -- can complicate diabetic treatment by causeing hyperglycemia in diabetics

25

What do you give to prevent peripheral conversion of T4 to T3 in thyroid storm

holy monkeys thyroid storm

propylthiouracil
IV sodium iodine
glucocorticoids
bb
diatrizoate and iohexol

26

MOA of diatrizoate and iohexol

iodinated radiocontrast medial that suupresses action fo 5'iodinase - no conversion of T4 to T3

use at tyrotoxicosis to decreased T3 concentraiton

27

Perchlorate
Thiocyanate
Pertechenetate
MOA

inhibit iodide concentation in gland by blockign transportation

28

Why do we care about amiodarone

*coat of many colours*

structural similarity with thyroxine

a) iodine associated hyperthyroidism
b) autoimmune mediated inflammatory version <-- treat with steroids
c) hypothyroidism due to blockade of T4 to T3

29

How to treat iodine associated hyperthyroidism caused by amiodarne

thiamides - propylthiouracil and metimazole

30

Lithium affect on thyroid style

inhibits release of hormones (hypothyroidism) and causes thyroid enlargement

31

Name some drugs that provoke autoimmune or destructive inflammatory thyroiditis to induce hypothyroidism

a) amiodarone
b) IFNalpa
c) IL-2
d) Litihium

32

What do these drugs have in common
a) amiodarone
b) IFNa
c) IL-2
d) Lithium

all provoke autoimmune or destructive inflammatory thyroidiits resulting in hypothyroidism

33

SHARK: Name three drugs that inhibit conversion of T4 to T3

corticosteroids
propranolol
amiodarone

34

Name some goitrogens

cabbage - thiocyantae (prevents uptake of I)
cassava - carbs _ thioc;yanate (prevents uptake of I with perchlorate and pertechetol)