Flashcards in thyroid and adrenal drugs Deck (19)
What drugs can be used to treat hyperthyroidism?
B- adrenoceptor antagonists for symptom relief
- radioactive iodine
Effects of B-adrenoceptor antagonist?
reduce some symptoms like tachycardia, dysrhythmias, angina, tremor, agitation
uses of B-adrenoceptor antagonists?
hyperthyroid crisis, prepare for thyroidectomy, waiting for effects of thionamides or radioactive iodine
MOA of thinoamides
inhibit iodination of tyrosine on thyroglobulin, leading to decreased T3/T4 synthesis, full effects seen a few weeks later after stores are depleted
uses of thionamides
short term use before surgery, long-term use in Graves disease as an alternative to surgery or radioiodine
ADRs of thionamides
cross placenta leading to congenital hypothyroidism, rashes in 2-2.5%, headaches, nausea, jaundice, joint pain, agranulocytosis leading to fever, mouth ulcers, sore throat, rash
MOA of iodine
Wolff-Charikoff block: inhibit iodide organification and thyroid hormone synthesis
uses of iodine
short term use, ~2 weeks, preparation for thyroidectomy, thyrotoxic crisis leads to decreased vascularity and gland size
MOA of radioactive iodine
Uses of radioactive iodine
hyperthyroidism and thyroid carcinoma, TFT - oral or i.v, .
How long does radioactive iodine work for, how is it administered?
peak effects in 2-4 months, is an oral/single dose
ADRs of radioactive iodine
hypothyroidism, thyroid cancer therefore not given in pregnant people or children
Treatments for hypothyroidism
T4 and T3
when is the max effect of T4?
ADRS of T4
small doses in the elderly due to risk of angina, dysrhythmias, or heart failure
how is T3 delivered?
i.v. speed of onset e.g. in myxoedema coma
What drugs can cause hypothyroidism?
amiodarone - causing antidysrhythmias, iodinated contrast media.
What drugs are used to treat hypercortisolism and hyperaldosteronism?
aminoglutethimide (inhibits cholesterol to pregnenolone) and ketoconazole (inhibits formation of corticosterone and hydrocortisone/cortisol)