Thyroid and Antithyroid drug list Flashcards Preview

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Flashcards in Thyroid and Antithyroid drug list Deck (27):
1

L-T4

Levothyroxine

2

L-T3

liothyronine sodium

3

mixture of L-T3 and L-T4

liotrix

4

What are the anti-thryoid drugs?

propylthiouracil, methimazole, carbimazole

5

3 proteins that bind T3 and T4

albumin, TBG, TBPA

6

What happens to the ratio of T4:T3 in iodine deficiency?

Goes from 4:1 to 1:3

7

T or F. IN the first trimester of pregnancy, the fetus relies on TH from maternal circulation.

T

8

How are T3 and T4 metabolized

in liver through glucuronide and sulfate conjugation. Enterohepatic circulation

9

____ transports T4 in CSF.

TTR

10

Describe the binding of TBG

The major carrier, T4 tighter.

11

Describe the binding of TTR (TGBPA)

Gets higher affinity after binding first T4

12

*Figure out what slide 50 means about "higher level in blood for TTR than TBG"

Because TTR has higher affinity (lower Ka)?

13

Describe binding of albumin

Both T3 and T4

14

What are immediated, later, and last effects of TSH

Immediate: increased secretion
Later: iodide uptake, hormone synthesis, proteolysis
Last: hypertrophy and hyperplasia

15

____ is the preferred method of preventing iodine deficiency.

Iodized salt

16

TH act primarily through binding ____ receptors.

nuclear

17

MOA of T3 and T4 at nucleus

T3: regulates transcription. Binds TRB1 and 2, TRa1. Binds mitochondrial membrane and activates enzymes.
T4: can bind same receptors but not regulate transription

18

What drugs are used in hyperthyroidism?

thioureylenes(methimazole, PTU), carbimazole,

19

MOA of PTU

inhibits peripheral conversion of T4 to T3, inhibit iodine organification

20

MOA of thioureylenes and carbimazole

inhibit iodine organification

21

Describe methimazole

10x more potent than PTU, crosses placenta and gets concentrated in fetal thyroid

22

What anti-thyroid drug is used in pregnant pt?

PTU- less placentral transfer and excretion in milk

23

Adverse reactions to PTU

minimal, agranulocytosis, skin rash

24

ADE of iodinated contrast medium

Euthyroid--> hyperthyroidism
Hyperthyroid--> thyroid storm

25

What do large doses of iodine do?

block release of TH, tx thyroid storm, decrease size and vascularity of gland--> preop!

26

What is radioactive iondine?

oral, concentrated in thryoid, B radiation will destroy parenchymal cells, no evidence of damage to other tissues,

27

Who can use radioactive iodine?

adults >35, NOT in women of child bearing age