thyroid diseses and its medication councelling

1. P R E S E N T E D B Y
D R . R E S H M A F R A N C I S
P H A R M D ( P B )
THYROID DISEASES

2. ANATOMY
• Over trachea
• Two lobes connected by an isthmus

3. THE THYROID GLANDS PRODUCE THYROID
HORMONES WHICH REGULATE
• the body's metabolic rate
• heart functions
• digestive function
• muscle control
• brain development
• mood and bone maintenance.
It’s correct functioning depends on having a good supply of
iodine from the diet.

4. HOW DOES THYROID HORMONE IS
FORMED?
TYROSINE
IODINE
Thyroid hormone
(T3 + T4)
TSH

5. REGULATION OF SECRETION

6. Thyroid diseases

7. TOO LITTLE THYROXINE?
HYPOTHYROIDISM
• Hyposecretion of thyroid hormone due to absence or
incomplete development of thyroid gland
• In children
Cretinism( stunted growth,mental retardation)

8. • In adults
Myxoedima

9. TOGETHER WITH
• Low metabolic rate
• Slow speech
• Poor appetite
• Weight gain
• Lethargy
• Bradycardia
• Sensitivity to cold
• Mental impairment
• Infertility
• Depression
• Stiffness of muscle

10. TREATMENT
• Replacement therapy with levothyroxin (T4)
• Given once daily.
• Steady state is achieved by 6-8weeks.

11. COUNSELLING POINTS
• Explain to patient that medication medication will
probably need to be taken for life.
• Instruct patient not to discontinue medication or change
dosage without consulting doctor.
• Instruct them not to switch from one brand to another
with out consulting doctor or pharmacist.
• Instruct the patient to take levothyroxin at same time
each day immediately after wake up.
• Instruct them to give 1 ½ hours gap between
levothyroxin and any food items including tea or milk
because fasting increases its absorption.
• Instruct patient to give a gap of 2 hours between
levothyroxin andother medications.

12. TOO MUCH THYROXINE?
HYPERTHYROIDISM/THYROTOXOCOSIS
• Over activity of thyroid gland.
Increased secretion of thyroid hormones.
Symptoms
• Tolerance to heat
• Weight loss
• Increased appetite

13. CONT…
• Increased bowel movement
• Irregular menstrual cycle
• Rapid/irregular heart beat
• Palpitation
• Tiredness
• Mood swings
• Irritability
• Tremor
• Hair loss
• Skin dryness

14. TREATMENT
Goal of therapy
• Decrease synthesis and/or additional hormone by
Removing part or
all of the thyroid
gland
Inhibiting synthesis of
the hormone
Blocking release of
the hormones from
the follicle

15. • Removing part or all of the thyroid gland by surgery
• Inhibiting synthesis of the hormone by using
propylthiouracil
carbimazole
• Blocking release of the hormones from the follicle
A pharmacologic dose of iodide inhibits the
iodination of tyrosine

16. COUNSELLING POINTS
• Advice patient to avoid iodine rich food items such as
shellfish, iodized salt etc.
• Inform patient that response to therapy may take
months.
• Instruct patients to report any symptoms like sore throat,
bruising or signs of any infection.