‫Thyroid gland disorders

Scientific Department Easy Pharmacology programme Present

Thyroid Hormone Disorders By Dr.MohamedAbdelrahman

Thyroid gland & Thyroid hormones Visit video department on pharmacist development website

Thyroid gland & Thyroid hormones ,[object Object]

The thyroid gland facilitates normal growth and maturation by maintaining the level of metabolism in the tissues that is optimal for their normal function. The two major thyroid hormones are T3 (triiodothyronine, the most active form), and T4(thyroxine). ,[object Object]

Regulation of secretion ,[object Object]

T4 is converted to T3 in the tissues. T3 combines with a receptor to stimulate subsequent protein synthesis necessary for normal metabolism.,[object Object]

Hypothyroidism ,[object Object]

in early life it causes cretinism, which is characterized by stuntedgrowth and mentaldeficiency.,[object Object]

One form is Hashimoto’s thyroiditis, an autoimmune condition where antibodies are produced against thyroglobulin.PretibialMyxedema Waxy infiltrative plaques and edema,

Treatment of hypothyroidism ,[object Object]

Hypothyroidism with goitrecan result (rarely) from deficiency of iodine in the diet; in which case treatment is with iodine supplementation.,[object Object]

Toxicity is directly related to thyroxine levels and manifests itself as nervousness, tachycardia, intolerance to heat and unexplained weight loss. ,[object Object]

Cholestyramine : May decrease thyroid hormone efficacy .

digitalis glycosides: May reduce effects of glycosides .

Fasting :Increases absorption of levothyroxin from GI tract.

Iron salts: May decrease efficacy of levothyroxine, resulting in hypothyroidism. ,[object Object]

Lactation :Minimal amounts excreted in breast milk.

Children :When drug is administered for congenital hypothyroidism, routine determinations of serum T4or TSH are strongly advised in neonates. In infants, excessive doses of thyroid hormone preparations may produce craniosynostosis. Children may experience transient partial hair loss in first few months of thyroid therapy .,[object Object]

Endocrine disorders: Therapy in patients with concomitant diabetes mellitus, diabetes insipidusor adrenal insufficiency (Addison's disease) exacerbates intensity of their symptoms. ,[object Object],[object Object]

Obesity :Drug should not be used for weight reduction; may produce serious or life-threatening toxicity in large doses, particularly when given with anorexiants .,[object Object]

Hyperthyroidism ,[object Object],Graves’s disease Goiter

Symptoms & treatment of Hyperthyroidism ,[object Object]

The goal of therapy is to decrease synthesis and/or release of additional hormone. This can be accomplished by removing part or all of the thyroid gland, by inhibiting synthesis of the hormones, or by blocking release of the hormones from the follicle. ,[object Object],[object Object],[object Object]

The effects of these drugs are slow in onset and thus they are not effective in the treatment of thyroid storm.,[object Object],[object Object],[object Object]

Carbimazole and PTU are taken with meals (to minimize GI irritation) and with same amount of food to facilitate uniform absorption.

Encourage fluid intake of 3 to 4 L/day, unless contraindicated .

Carbimazole and PTU have relatively rare adverse effects include agranulocytosis, rash, and edema. this is rare and reversible on stopping drug therapy.,[object Object]

Beta blockers: Increased effects of beta blockers.

Digitalis glycosides: Increased digitalis levels, resulting in toxicity.

Theophylline: Altered theophylline clearance in hyperthyroid or hypothyroid patients. ,[object Object]

Lactation:Avoid nursing. However, if antithyroid drug is essential, PTU is preferred antithyroid agent while nursing.

Children:Hepatotoxicity has occurred in pediatric patients. Discontinue drug immediately if signs and symptoms of hepatic dysfunction develop

Agranulocytosis: Potentially most serious side effect. Discontinue drug if agranulocytosis, aplastic anemia, hepatitis, fever, or exfoliative dermatitis occur. Hemorrhagic effects:May cause hypoprothrombinemia and bleeding.,[object Object]

General notes ,[object Object]

Caution patient not to take OTC or other prescribed medications without consulting physician .

Instruct patient to check pulse daily

Do not switch from one brand to another without comparison studies of bioavailability.Lipid lowering agents : rapid review

Advise patient to monitor weight at least 2 to 3 times/wk or per physician instruction, obtaining weight at same time, using same scale. Encourage patient to keep recorded chart.

Instruct patient to notify dentist or physician of drug regimen before surgical or dental procedures. secretion of thyroxin hormone : video

Practical notes on levothyroxin ,[object Object]

‫Thyroid gland disorders

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