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11 Cards in this Set

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*** #1 - Thyroid and Anti-thyroid Drugs***
***Thyroid and Anti-thyroid Drugs***
what decreases its absorption?
what drugs' effects are increased by thyroxine?
what drugs' effects are decreased by thyroixine?
uses? (3)
calcium carbonate decreases its absorption

increases: warfarin, TCAs, amiodarone

decreases: oral contraceptives, cholestyramine, rifampicin

uses: hypothyroidism, myxedema, coma, nodular thyroid disease
Two important drugs?
What's a mechanistic advantage of PTU?
What type of inhibition?
Which drug is more potent?
Which drug is preferred for pregnant women and nursing moms?
Adverse reactions?
Propylthiouracil (PTU), Methimazole, (Carbimazole not in U.S.)

MOA: inhibits iodine organification (i.e. inhibits the peroxidase catalyzed reactions: iodination and coupling)

PTU advantage: inhibits peripheral conversion of T4-->T3

the inhibition is IRREVERSIBLE

Methimazole is 10X more potent; PTU has shorter t1/2

Both drugs cross placental barrier, but PTU is preferred b/c it crosses placenta less and into breast milk less

Minimal # of pts get S/Es:
agranulocytosis (sign: sore throat)
granulocytopenia (get leukocyte counts)
skin rash
uses? (2)
when not to use it?
must use with?
MOA: inhibits iodide uptake at HIGH DOSES; in time, lowers synthesis of I- pump so you lose I- in cells

Uses: pre-op treatment; thyroid storm

Don't use: prior to radioactive iodide treatment**

Must use with: PTU or methimazole
Radioactive iodine:
alternative to what?
how is it given?
what do you do after giving it?
who can you use it in?
disadvantage/side effect?
Radioactive iodine:
alternative to surgery

give Na+ 131-I orally

use Beta and Gamma radiation to destroy thyroid gland

used in adults >35, but not in child-bearing age females

may cause delayed hypothyroidism (due to overtreatment)
Beta-blockers: (i.e. Propranolol)
why are they used for hyperthyroidism?

what do they do?
Beta-blockers: (i.e. Propranolol)
hyperthyroidism causes increased # of B-adrenergic receptors in heart --> high HR and contractility

Beta-blockers help against cardiac S/Es of hyperthyroidism; also lowers conversion of T4 to T3
Anion inhibitors:
uses in hyperthyroidism?
Anion inhibitors:

used as diagnostic tool; high toxicity
What drug class inhibits coupling?
What drug class inhibits hormone action in periphery?
Beta-blockers (Propranolol)
Preferred drugs for treatment of thyroid storm?
PTU* (blocks T4 --> T3)

high dose iodide
IV hydrocortisone
Acetaminophen (for fever)
*** #2 - Geriatric Psychopharm***
*** #2 - Geriatric Psychopharm***