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15 Cards in this Set
- Front
- Back
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Levothyroxine sodium
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sodium salt of T4
admin = normal levels of T4 and T3 DRUG OF CHOICE may be used to prevent goiterous effects of other therapeutic agents: lithium, amniosalicylic acids, sulfonamide compounds (some) |
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Liothyronine sodium
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sodium salt of T3
NOT preferred for maintenance therapy since short T 1/2 and duration of action Preferred for initial therapy in MYXEDEMA+ MYXEDEMA COMA due to short T 1/2 and BETTER GI ABSORPTION monitoring difficult since BLOOD FLUCTUATION POST DOSE USE: T3 suppression: diff hyperthyroid from euthyroidism; short term suppression of a solitary thyroid nodule before radioactive iodine scan |
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Liotrix
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4:1 mix of levothyroxine:liothyronine
equivalent to levothyronine alone since T4, T3 in periphery Therefore, no specific advantage to mix |
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Thyroid USP
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From dried defatted thyroid glands of cattle, sheep, pigs
TH varies somewhat btwn species thus T4/T3 amounts may not be sufficient to produce desired effect seldom used |
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Thyroglobulin
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Potentially purified extract of frozen porcine thyroid
contains T3 and T4 more expensive and no practical advantage of thyroid USP initiating therapy with thyroglobulin is NO longer recommended seldom used |
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hyperthyroidism agents
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MOA: active transport of iodine, iodination of thyroglobulin, coupling rxn, hormone/excretion/inactivation, iodotyrosine deiodination, peripheral iodtyrosine deionization
Thyrotoxicosis: graves dz, toxic micronodular goiter, thyroiditis, single hyperfunctioning thyroid nodules, inhib thyroidal secretion, dec amount of functional use (surgery, radiation w/ 131 I), LEADS TO HYPOTHYROIDISM ==> REPLACEMENT FOR LIFE Tx: sedation, oxygen, dec body T, admin of antithyroid meds, iodine, corticosteroids, fluids, electrolytes, beta blockers |
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Methimazole
(Inhib of thyroid hormone synthesis) |
Similar to propyluracil but NO inhib of T4 to T3
approximately 10x more potent T1/2 longer |
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Propyluracil + Methyiouracil
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Thiorea derivatives t1/2 1-9 hours
MECH INTERFERES WITH INCORPORATION OF I- INTO THYROGLOBULIN Note: propyluracil also inhibs --> coupling of iodotyrosine to form T3 and T4; inhibs T4 conversion to T3 in periphery Little or no effect on breakdown or release of existing TH used in Europe, not US |
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Inhibitors of thyroid hormone synthesis
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ADRs: skin rash (5%), arthralgia, myalgia, CHOLESTATIC JAUNDICE, drug fever, PSYCHOSIS, LYMPHADENOMPATHY, LUPUS LIKE SYNDROME
Serious: granulocytopenia, agranulocytosis |
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Carbimazole
(Inhib of thyroid hormone synthesis) |
prodrug of methimazole
used in Europe |
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Potasium Percholate
(KCl04) |
Mech: INHIB ANIONIC PUMP; INTERFERES WITH I- TRANSPORT INTO THYROID GLAND
can cause fatal APLASTIC ANEMIA NO longer considered therapeutically useful |
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Postassium Iodide (thyroblock)
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transiently inhibs organic iodine formation
blocks hormone release block accumulation of radioiodine (useful in nuclear power plant accidents) |
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Lithium Carbonate
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Tx: manic depressive states
prevents the release of iodine from thyroid gland No advantage over other agents eventual "iodine escape" therefore no therapeutic use in long term OFTEN A CAUSE OF HYPOTHYROIDISM |
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Iodine 131
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MICROCURIE amounts are diagnostic
MILLICURIE amounts for selective destruction Beta particle emissions I131 results in HYPOthyoridism in Graves dz |
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Adjunct: beta blockers propanolol
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ALLEVIATE MANY SIGNS/SX OF THYROTOXICOSIS
Dec hyperthyroid induced tachy, tremor, sweating, heat intolerance, anxiety Use: short term for thyrotoxic neonates, thyrotoxic crisis; inf for long term tx; not used alone CI: obstructive airway dz blocks bronchodilation, DM causes hyperglycemia |
