1.
Action of radioiodide: destroys thyroid gland w/o injury to adjacent tissue at proper doses
2.
Action of thioamides: inhibit peroxidase enzymes catalyzing oxidation of I & coupling of iodinated tyrosel groups--> decr snthesis of thyroid hormones, C= prodrug of methimazole, converted to active drug inside body
3.
Adverse effects of Potassium iodide: allergic rxn, iodism, not used long term
4.
Adverse effects of radioiodide: delayed hypothyroidism
5.
Adverse effects of Thioamides: skin rxns, GI upset, agranulocytosis, goiter, hypothyroidism
6.
Antithyroid agents used to tx Hyperthyroidism: potassium iodid, radioiodide, thioamides (propylthiouracil, methimazole, carbimazole), beta-adrenergic antagonists, dilitiazem
7.
Dilitiazem action as antithyroid agent: Adjunct, Ca channel blocker
8.
Effects of thyroid hormone: norm growth & development, incr BMR, thermogenic effect (incr heat prod), incr plasma glucose, plasma [], CV activity; maturation & development of CNS
9.
MoA of T3 & T4: inhibit hypothalamus & ant. Pit. To produce TSH & TRH--> too much iodide inhibits thyroid
10.
MoA of thyroid hormones: activation of nuclear receptors attached to DNA leading to transcription of mRNA --> incr synthesis of specific proteins which produce effects; T3 is 10x more potent than T4 for binding receptors
11.
Potassium iodid action as antithyroid agent: incr [] produce an autoinhibition of I uptkae, decr release of thyroid hormones
12.
Regulation of thyroid hormone synthesis/secretion: controlled by Hypothalamus, Ant. Pituitary, & Thyroid; TSH- released by Ant Pit, controls thyroid fxn--> prod of T3 & T4; TRH- produced by hypotalamus, acts on ant. Pit
13.
Thyroid Gland Hormones: Calcitonin, Thyroxine (T4), Triiodothyronine (T3)
14.
Thyroid Hormone actions: T3 & T4 dissociated from thyroid binding proteins, free to enter cell, T4 converted to T3, T3 enters nucleus, binds to T3 receptor proteins (alpha & beta), different [] of the receptor form in different tissues
15.
Thyroid Hormone Synthesis & Secretion: uptake of circ iodid--> forms T3 & T4, secretion of T3 & T4, T4 convert to T3 by liver & kidney
16.
Thyromimetic agents used to tx hypothyroidism: levothyroxin (T4), liothyronine (T3), liotrix (T3 & T4), thyroid
17.
Uses of beta-adrenergic antagoinsts as antithyroid agents: adjunct (propanolol, atenolol), control CV effects of hyperthyroidism
18.
Uses of dilitiazem as antithyroid agent: adjunct, used to relieve supraventricular arrhythmias
19.
Uses of potassium iodide: axns occur in 207 days, given as saturated soln of KI or LUGOL's solution (rarely
20.
Uses of radioiodide: hyperthyroidism, thyroid cancer
21.
Uses of thioamides: hyperthyroidism- delayed onset of meds by 3-4 weeks
22.
What is levothyroxine?: T4, available for inj, preferred for therapy- longer 1/2 life, long duration allows 1x/day therapy, better standardizaiton & stability
23.
What is liothyronine?: T3, expensive, multiple daily dosing, harder to monitor
24.
What is liotrix?: T3 & T4, increased cardiotoxicity
25.
What is thyroid as a thyromimetic agent?: thyroid powder from animals, older prep no longer preferred
26.
What is TRH: produced by hypothalamus, acts on ant. Pit.
27.
What is TSH: released by Ant. Pit., controls thyroid fxn--> production of T3 & T4
28.
Which is more potent in binding receptors, T3 or T4?: T3 is 10x more potent