28786616-Anti-Thyroid-Drugs

28786616-Anti-Thyroid-Drugs - Just A REVIEW on the thyroid...

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Unformatted text preview: Just A REVIEW on the thyroid y Located at the base of the throat, inferior of the Adam s apple Large gla , i-l e ,c ecte y a ce tral ist us 2 hormones secreted y Iodide containing hormones y T3 triiodothyronine y T4 thyroxine y Calcitonin y How do yo control it? Synthesis of thyroid hormones Food Thyroid follicle tyrosine MIT, DIT Iodine s pplements 2 DIT = T4 MIT + DIT = T3 Synthesis of thyroid hormones I Food Thyroid deiodinase Thyroid follicle tyrosine thyroglob lin MIT, DIT Iodine s pplements 2 DIT = T4 MIT + DIT = T3 y The hypothalam s and anterior pit itary y Control the secretion of thyroid hormones thro gh two negative feedback loops Hypothalam s Anterior pit itary TSH Thyroid T3 T4 Effects of Thyroid Hormone y For normal growth and development of the nervo s, skeletal, and reprod ctive systems y Controls the metabolism of fats, carbohydrates, proteins and vitamins Clinical Use: Hypothyroid States y Hormone therapy with either T3 or T4 y Synthetic levothyroxine (T4) is the form of choice in most cases y Triiodothyronine (T3) is faster acting b t has a shorter halflife and more expensive y Levothyroxine, Liothyronine, Liotrix y THYROTOXICOSIS y Warm, moist skin y Sweating, heat intolerance y Tachycardia y Increased appetite y Nervo sness y Decreased fertility y Nervo sness y exopthalmos y HYPOTHYROIDISM y Pale, cool skin y Cold sensation y Bradycardia y Red ced appetite y Lethargy y Weight gain Anti-Thyroid Drugs y Thioamides y Propylthio racil, Methimazole y MOA: block iodination of tyrosine resid es of thyroglob lin and blockade of co pling of DIT and MIT y Synthesis of thyroid hormone is inhibited rather than release y ORAL y Usef l in patients with ncomplicated hyperthyroidism Contraindications: y Methimazole is containdicated in pregnant and n rsing women, PTU maybe given Toxicity: y Skin rash (common), imm ne eactions y Reversible effects y Iodine salts and Iodine y L gol s sol tion (iodine and potassi m iodide), sat rated sol tion of potassi m iodide y MOA: inhibition of iodination of tyrosine in thyroid gland and thyroid hormone release y Decreases the size and vasc larity of the hyperplastic thyroid gland y Faster onset of action y Use: y Thyroid storm, severe thyrotoxicosis, preparation of patients for s rgical resection of the thyroid y Radioactive Iodine y 131I radioactive isotope y MOA: destr ction of the thyroid follicle y Allows permanent c re of thyrotoxicosis y CI: pregnant and n rsing women Hashimoto s Thyroiditis y An a toimm ne disorder which impairs the thyroid's ability to prod ce hormones y Pit itary gland attempts to stim late the thyroid gland to prod ce more thyroid hormones, ca sing yo r thyroid gland to enlarge Graves' disease y a toimm ne disorder, is the most common ca se of an overactive thyroid y antibodies prod ced by yo r imm ne system stim late the thyroid to prod ce too m ch thyroxine Corticosteroids y steroid hormones that are prod ced in the adrenal cortex. y Corticosteroids are involved in a wide range of physiologic systems s ch as y stress response y imm ne response y reg lation of inflammation y carbohydrate metabolism y protein catabolism y blood electrolyte levels y behavior y Glucocorticoids s ch as cortisol control carbohydrate, fat and protein metabolism and are anti-inflammatory by preventing phospholipid release, decreasing eosinophil action and a n mber of other mechanisms y Mineralocorticoids s ch as aldosterone control electrolyte and water levels, mainly by promoting sodi m retention in the kidney Biosynthesis Classes of corticosteroids y Group A y (short to medi m acting gl cocorticoids) y Hydrocortisone y Hydrocortisone acetate y Cortisone acetate y Tixocortolpivalate y Prednisolone y Methyprednisolone y Prednisone y Group B y Triamcinoloneacetonide y Triamcinolone alcohol y Mometasone y Amcinonide y B desonide y Desonide y Fl ocinonide y Fl ocinoloneacetonide y Halcinonide y Group C y Betamethasone y Betamethasone sodi m phosphate y Dexamethasone y Dexamethasone sodi m phosphate y Fl ocortolone y Group D y Hydrocortisone-17-b tyrate y Hydrocortisone-17-valerate y Aclometasonedipropionate y Betamethasonevalerate y Betamethasonedipropionate y Prednicarbate y Clobetasone-17-b tyrate y Clobetasol-17-propionate y Fl ocortolonecaproate y Fl ocortolonepivalate y Fl prednidene acetate Therapeutic outcomes y Gl cocorticoids y Red ced pain and inflammation y Minimized shock syndrome and faster recovery y Red ced na sea and vomiting associated with chemotherapy Types of Corticosteroids y Topical steroidfor se topically on the skin, eye, and m co s membranes. y Inhaled steroids for se to treat the nasal m cosa, sin ses, bronchii, and l ngs y Oral forms - s ch as prednisone and prednisolone. y Systemic forms - available in injectibles for se intraveno sly and parenteral ro tes MINERALOCORTICOIDS y Fl drocortisone y Is an adrenal corticosteroid with potent mineralocorticoid and gl cocorticoid effects. y Affects fl id and electrolyte balance by acting on the distal renal t b les y Used in combination with gl cocorticoids to replace mineralocorticoids activity in patients who s ffer from adrenocortical ins fficiency and to treat salt-losing adrenogenetal syndrome. I am not on STEROIDS Yo are THE ANIMAL!!!!! Thank yo very M ch!!!! ...
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This note was uploaded on 05/16/2011 for the course NURSING 112 taught by Professor Brinley during the Spring '11 term at Pace.

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