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39 Cards in this Set

  • Front
  • Back
converts T4 to T3
5-deiodinase
where does T3 bind intracellularly
nuclear receptors in the nucleus
what is more potent, T4 or T3
T3
when should thyroxine be stopped
angina pectoris
cardiac arrhythmia
adverse effects of thyroxine in elderly patients
increased risk of atrial fibrillation
accelerated osteoporosis
needed for early development of the fetal brain
maternal thyroxine
adverse effect includes risk of fetal hypothyroidism
methimazole
*propylthiouracil is preferable because doesn't cross placenta as easily
mechanism of axn of thioamides
inhibit thryoid peroxidase-catalyzed reactions that form thryoglobulin
which thioamide also inhibits peripheral conversion of T4 to T3 and is therefore preferred inthe treatment of thryoid storm
propylthiouracil
thioamides
propylthiouracil
methimazole
antithryoid drug associated with an altered sense of taste and smell
methimazole
adverse effects of thioamides
maculopapular rash
agranulocytosis
altered taste and smell (methimazole)
risk of fetal hypothyroidism (methimazole)
monovalent anions that resemble iodide and block the uptake of iodine by thyroid gland
perchlorate
pertechnetate
thiocyanate
clinical use of anion inhibits
Grave's disease
amiodarone-induced hyperthyroidism
anion inhibitor associated with aplastic anemia
ClO4
Wolff-Chaikoff effect
acute inhibition of thyroid hormone synthesis secondary to large ingestion of iodine
mechanism of axn of iodide
inhibits hormone release through inhibiting thryoglobulin proteolysis and inhibits synthesis via thyroidal peroxidase
what should always be administered before iodides are given
thioaminde therapy
when should iodide therapy not be used
If radioactive therapy is needed
associated with B ray emission and destroys thryoid tissue
radioactive iodine (I-131)
adverse effects of radioactive iodine
crosses the placenta and destroys fetal thryoid
*should not be given to pregnant or nursing mothers
associated with containing large concentration of iodine and causing suppression of thryoid gland by Wolff-Chaikoff effect
ipodate - radiocontrast agent
amiodarone - antiarrhythmic
preferred antithyroid drug used in pregnancy
propylthiouracil
2 action of propanolol in thyrotoxicosis
1. B-blocker to reduce symptoms
2. inhibits 5-deiodinase to block peripheral conversion of T4 to T3
indication for iodide therapy
thyroid storm
preparation for surgery
lithium
inhibits thyroid hormone release
treatment protocol for thyroid storm
1. propanolol
2. propylthiouracil
3. KI
4. levothyroxine
preferred treatment for Grave's disease in most patients over 21
radioactive iodine
what is given before radioactive iodine in patients with heart disease or severe thyrotoxicosis
methimazole until euthryoid
treatment protocol for thyroid storm
1. propanolol
2. propylthiouracil
3. potassium iodide
4. hydrocortisone
treatment for subacute thyroiditis
propanolol
aspirin and corticosteroids
Levothyroxine
T4
Liothyronine
T3
why do thioamides that 3-4 weeks for full effect to take place
because they do not inhibit the release of preformed thyroid hormone, only the axn of making new ones
why do iodide salts have onset of action rapid compared to thioamides
because they inhibit the release as well as synthesis of thyroid hormones
amiodarone can cause what two thyroid conditions, mechanism
hypothyrodism - blocks peripheral conversion of T4 to T3
hyperthyroidism - iodine-induced mechanism or inflammatory mechanism
treatment of iodine vs. inflammatory-induced hyperthryoidism in amiodarone-induced hyperthyroidism
iodine-induced - thioamides
inflammatory-induced - corticosteroids
Lugol's solution
KI and Iodine
what decreases the size and vascularity of the hyperplastic thyroid gland
Iodide