This document summarizes thyroid hormone synthesis and regulation. It discusses that the thyroid gland secretes three hormones: thyroxine (T4), triiodothyronine (T3), and calcitonin. T4 and T3 are synthesized through a process involving iodine uptake, oxidation, iodination of tyrosine residues, and coupling reactions. T4 has lower activity than T3, which is produced from peripheral conversion of T4. The hormones act through nuclear receptors to increase metabolism. The document also outlines treatments for hyperthyroidism including antithyroid drugs, iodine, beta blockers, and radioactive iodine, which destroy the thyroid tissue.
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Summary of thyroid and antithyroid drugs
-Introduction
-Synthesis
-Pharmacological Action
-Mechanism of action
-Drugs in Hypothyroidism
-Thyroid Inhibitors
-Drugs in Hyperthyroidism
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Summary of thyroid and antithyroid drugs
-Introduction
-Synthesis
-Pharmacological Action
-Mechanism of action
-Drugs in Hypothyroidism
-Thyroid Inhibitors
-Drugs in Hyperthyroidism
Introduction.
Biosynthesis
Types of Thyroid diseases
Thyroid Drugs
Antithyroid Drugs
Mechanism of action
Structure
Adverse Drug Reactions and Uses.
Reference
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
Serotonin is major neurotransmitter and affects the physiology of our body. Serotonin antagonists are used in various pathological conditions of body. This is a small presentation showing feature of serotonin.
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
this will give brief about the peptic ulcer and give information about the drug used for peptic ulcer and classification of drugs including drugs and there use adverse effect.
The content of presentation is as follows
- introduction to thyroid
- thyroid hormone synthesis
- type of thyroidism
- difference between hyperthyroidism and hypothyroidism
-treatment of hypothyroidism
- anti thyroid drug classification
- mechanism of anti thyroid drugs
-
Introduction.
Biosynthesis
Types of Thyroid diseases
Thyroid Drugs
Antithyroid Drugs
Mechanism of action
Structure
Adverse Drug Reactions and Uses.
Reference
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
Serotonin is major neurotransmitter and affects the physiology of our body. Serotonin antagonists are used in various pathological conditions of body. This is a small presentation showing feature of serotonin.
5-Hydroxytryptamine & it’s Antagonist is a Topic in Pharmacology which will defiantly Help You in pharmacy field All information is related to pharmacology drug acting and it's effect on body. it is collage project given by our department i would like to share with you.
this will give brief about the peptic ulcer and give information about the drug used for peptic ulcer and classification of drugs including drugs and there use adverse effect.
The content of presentation is as follows
- introduction to thyroid
- thyroid hormone synthesis
- type of thyroidism
- difference between hyperthyroidism and hypothyroidism
-treatment of hypothyroidism
- anti thyroid drug classification
- mechanism of anti thyroid drugs
-
Thyroid and anti-thyroid drugs. Synthesis of thyroid hormoneAnkita
In this ppt we will get idea about thyroid and anti-thyroid drugs. how and where the thyroid hormone synthesis occur. regulation of thyroid hormone. get brief knowledge about anti-thyroid drugs, their action, MOA, adverse effect of anti-thyroid drugs and uses
Hello there!
This is Jayhind Bharti from M-Pharmacy 1st year pharmacology,
the above uploaded ppt is on the topic anti-thyroid drug from "advance pharmacology - 2" of m pharm 2nd semister
initially i have discussed about the basics of thyroid gland, its synthesis procedure, what are its pharmacological action and all
further our main topic starts in which i have listed the class of drug which are used to treat hyper- thyroidism with their examples and have explained the moa of each class wit their possible adverse effect, side effect, advantages and disadvantages
lastly i have added some recent advancements in the field of anti- thyroid drug
the above presentation contain the history of the thyroid disorder, including the definition of thyrotoxicosis, and its two main cause that are graves' disease and another toxic nodular goiter and the classification of drugs that are used in hyperthyroidism i.e. hormone sythesis inhibitor, hormone release inhibitors, destroy thyroid tissue, and inhibit ionic trapping with it's example including the adverse effect and side effect and marketted preparation of the same and the agents which cause hypothyroidism and the agents which are used to prescribe in the pregnancy
Thyroid Gland and Disease of Thyroid GlandRanadhi Das
The thyroid gland is one of the largest endocrine glands.
The thyroid gland is located immediately below the larynx and anterior to the upper part of the trachea. It weighs about 15-20g.
It consists of 2 lateral lobes connected by a narrow band of thyroid tissue called the isthmus.
The isthmus usually overlies the region from the 2nd to 4th tracheal cartilage.
a brief on thyroid gland covering following titles:
Introduction
Anatomy and physiology of thyroid gland
Synthesis of thyroid hormones
Regulation
Mechanism of action
Biological function
The thyroid hormones, triiodothyronine (T3) and its prohormone, thyroxine (T4), are tyrosine-based hormones produced by the thyroid gland that are primarily responsible for regulation of metabolism. Iodine is necessary for the production of T3 and T4. A deficiency of iodine leads to decreased production of T3 and T4, enlarges the thyroid tissue and will cause the disease known as simple goitre. The major form of thyroid hormone in the blood is thyroxine (T4), which has a longer half-life than T3.The ratio of T4 to T3 released into the blood is roughly 20 to 1. T4 is converted to the active T3 (three to four times more potent than T4) within cells by deiodinases (5'-iodinase). These are further processed by decarboxylation and deiodination to produce iodothyronamine (T1a) and thyronamine (T0a). All three isoforms of the deiodinases are selenium-containing enzymes, thus dietary selenium is essential for T3 production.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
4. SYNTHESIS AND RELEASE OF HORMONE
I. Uptake of plasma iodide by the
follicle cells (Iodide trapping)
II. Oxidation of iodide and iodination
of tyrosine (Oxidation & iodination)
III. Coupling
IV. Storage and release
V. Peripheral Conversion of T4 to T3
5. I. IODINE TRAPPING:
Energy dependent process against
a gradient (Na+
/I-
symport; NIS)
Trapping is also present in other
gland but not stimulated by TSH
II. OXIDATION & IODINATION:
I-
to I+
with the help of H2O2 &
catalysed by peroxidase enzyme
I+
combine with tyrosine to form
MIT and DIT
6. III. COUPLING:
MIT and DIT couple together to form T3 and
T4
Peroxidase enzyme catalyse
Takes place in and facilitated by
Thyroglobulin (TG)
IV. STORAGE AND RELEASE:
These thyroglobulin remains stored as
thyroid colloid in the interior of follicles
Taken into cell by endocytosis; lysosomal
protease breaks down
T3, T4 is secreted & MIT, DIT are deiodinated
and utilised
8. V. PERIPHERAL CONVERSION OF T4
TO T3:
T3 (low concentration) is an active
form
Liver & kidney convert T4 to T3
Inhibitor - Propyl thiouracil,
propranolol (highdose), amiodarone
and glucocorticoids
9. TRANSPORTATION, METABOLISM &
EXCRETION:
Highly plasma protein bound
Thyroxine binding protein (TBG),
Thyroxine binding prealbumin, Albumin
Metabolised by deiodination and
conjugation in liver (kidney & salivary
gland)
Metabolite undergo enterohepatic
circulation
t1/2 of T4 = 6-7 days: t1/2 of T3 = 1-2 days
10. MOA: Both T3 and T4 penetrates cells by active
transport & binds to nuclear thyroid hormone
receptor bound to the thyroid hormone response
element (TRE)
Conformation changes occur (heterodimerization of
receptor with retinoid X receptor (RXR)) & releases
coreporessor and binding of coactivator occurs
Gene transcription induced production of specific
mRNA and proteins
Metabolic and anatomic effects.
12. ACTIONS
Affect whole body
Growth and development:
Essential for normal growth & development
Congenital deficiency- milestones of
development are delayed (mental retardation)
Metabolism
↑ BMR
Lipolysis - ↑ free fatty acid, LDL level ↓
Carbohydrate- ↑ peripheral utilization,
glycogenolysis, gluconeogenesis &
absorption - hyperglycemia
Protein- Catabolism
13. CVS:
↑ Sensitivity & number of beta receptor -
↑HR, contractility and CO
Skeletal muscle:
Hypothyroidism- flabby and weak
Hyperthyroidism- ↑ muscle tone, tremor,
weakness
GIT: Propulsive activity ↑es with hormones
Haemopoiesis: Hypothyroidism- anaemia
Reproduction:
Hypothyroidism- impaired fertility
Preparations:
l-thyroxine sod. 25, 50, 75, 100 mcg- T4
(commonly used)
14. USES:
1. Cretinism:
2. Adult hypothyroidism:
Symptoms
↓T3 & T4 and ↑TSH
Levothyroxine - in empty stomach
50 mcg ODX 3wks then 100mcg OD for 3
wks----- Davidson’ medicine
↓Weight & periorbital puffiness in 2-3weeks
Subclinical Hypothyroidism
3. Myxoedema coma:
4. Nontoxic goiter:
15. Thyroid inhibitor- reduce thyroid
activity and hormonal effect
Used in thyrotoxicosis
Thyrotoxicosis means an excess of thyroid
hormone in the body.
Graves' disease is the major cause of
hyperthyroidism. Other causes
include multinodular goiter, toxic
adenoma, inflammation of the thyroid &
taking too much iodine.
THYROID INHIBITORS
16. CLASSIFICATION
1. Hormone synthesis inhibitor (Antithyroid
drugs): Propylthiouracil, Carbimazole,
Methimazole
2. Ion trapping inhibitor: Thiocyanates,
Perchlorates, Nitrates
3. Hormone release inhibitor: Iodine,
Sod. and pot. Iodides
4. Destroy thyroid tissue: Radioactive
iodine (131
I, 125
I, 123
I)
PROLONG USE CAUSE HYPOTHYROIDISM:
Lithium, Amiodarone, Sulfonamide, Phenytoin,
Carbamazepine, rifampin, Phenobarbitone
17. ANTITHYROID DRUGS (Thioamides)
MOA: Inhibit synthesis by binding to
peroxidase enzyme & preventing its
action
Inhibit iodination of tyrosine residues in
thyroglobulin
Inhibit coupling of iodotyrosine residues
to for T3 and T4
Thyroid colloid is depleted over time and
blood levels of thyroid hormones are
progressively lowered.
Propylthiouracil (PTU), in addition,
inhibit peripheral conversion of T4 to T3
Carbimazole (prodrug) converts to
18. Antithyroid drugs Contd………
Pharmacokinetics
Quick oral absorption
Concentrate in gland – large Vd
Enter milk, cross placenta
Metabolised in liver
Adverse effects
Reversible hypothyroidism & goiter on
overtreatment
GI intolerance, skin rashes & joint pain-
important
Loss or graying of hair, loss of taste, fever
& liver damage- infrequent
Reversible agranulocytosis- rare but serious
19. Antithyroid drugs Contd………
Propylthiouracil Carbimazole
Less potent More potent
High plasma proteinLess plasma protein
bound bound
Less excrete in milk More
& less cross placenta
Short t1/2 Long t1/2
Multiple dosing Single dosing
No active metabolite Converts to
methimazole (active)
Inhibit peripheral No action
conversion of T4- T3
20. USES:
Thyrotoxicosis
Grave’s Disease
Toxic Nodular Goiter
Make patient euthyroid before
thyroidectomy
Along with 131
I therapy
21. IODINE AND IODIDES:
Fastest acting: initially cause “thyroid
constipation” ; but after 10-15 days, “thyroid
escape”
MOA: Inhibition of hormone release- termed
as ‘thyroid constipation’
Inhibits Endocytosis of colloid and
proteolysis of thyroglobulin.
Excess of iodine inhibits its own transport
by interfering with expression of NIS
Lugol’s iodine (5% iodine in 10 % potassium
iodide solution)
22. USES (iodine & iodide):
1. Preoperative preparation: 10 days before
thyroidectomy
2. Thyroid strom
3. Prophylaxis of endemic goiter
4. Antiseptic
ADVERSE EFFECT (iodine & iodide):
1. Acute reaction: Sensitive person- swelling of lip
& eyelids, fever, joint pain etc
2. Chronic overdose (iodism): Inflammation of
mucous membranes, salivation, rhinorrhoea,
sneezing, lacrymation, swelling of eyelids,
burning sensation in mouth, headache, rashes,
GI symptoms etc
23. RADIOACTIVE IODINE:
131
I - therapeutic value
125
I, 123
I - Diagnosis (rarely used)
131
I emits γ rays & β particles
β radiation (cytotoxic action) penetrate 0.5-
2 mm only
Dose - calculated in millicurie
MOA: Given single dose orally as sod 131
I –
concentrate in thyroglobulin→ β particles
destroy thyroid parenchyma (few weeks)
24. β ADRENERGIC BLOCKER:
Propranolol, Metoprolol, Atenolol etc (without
intrensic sympathomimetic activity) – effective
adjuvant
Quick symptomatic relief (palpitation,
tremor, nervousness, sweating, myopathy)
without altering hormone level
Propranolol (widely used) in high dose
(160mg /day) reduce T3 level approx. 20% by
inhibiting peripheral conversion
Uses: Thyrotoxic crisis, while awaiting
response to carbimazole or 131
I , preoperative
preparation before surgery
Editor's Notes
Signs of hypothyroidism: Dry skin, decreased sweating, thinning of the epidermis, and hyperkeratosis of the stratum corneum. Increased dermal glycosaminoglycan content traps water, giving rise to skin thickening without pitting (myxedema). Typical features include a puffy face with edematous eyelids and nonpitting pretibial edema. There is pallor, often with a yellow tinge to the skin due to carotene accumulation. Nail growth is retarded, and hair is dry, brittle, difficult to manage, and falls out easily. In addition to diffuse alopecia, there is thinning of the outer third of the eyebrows, although this is not a specific sign of hypothyroidism.
Other common features include constipation and weight gain (despite a poor appetite). The weight gain is usually modest and due mainly to fluid retention in the myxedematous tissues. Libido is decreased in both sexes. Fertility is reduced and the incidence of miscarriage is increased.
Myocardial contractility and pulse rate are reduced, leading to a reduced stroke volume and bradycardia. Blood flow is diverted from the skin, producing cool extremities. Fluid may also accumulate in other serous cavities and in the middle ear, giving rise to conductive deafness. Pulmonary function is generally normal, but dyspnea may be caused by pleural effusion, impaired respiratory muscle function, diminished ventilatory drive, or sleep apnea.
Memory and concentration are impaired. Rare neurologic problems include reversible cerebellar ataxia, dementia, psychosis, and myxedema coma. The hoarse voice and occasionally clumsy speech of hypothyroidism reflect fluid accumulation in the vocal cords and tongue.