THYROID AND

ANTITHYROID DRUGS
Just A REVIEW on the thyroid
Located at the base of the throat, inferior of the
Adam’s apple
Large gland, bi-lobed, connected by a central isthmus
 2 hormones secreted
Iodide containing hormones
T3 – triiodothyronine
T4 – thyroxine
Calcitonin

How do you control it?

Synthesis of thyroid hormones
Thyroid follicle
Food tyrosine

MIT, DIT

Iodine 2 DIT = T4
supplements MIT + DIT =
T3
Synthesis of thyroid hormones
I
Thyroid follicle
Food tyrosine
Thyroid thyroglobulin
deiodinase

MIT, DIT

2 DIT = T4
Iodine
MIT + DIT = T3
supplements
The hypothalamus and anterior pituitary
Control the secretion of thyroid hormones through two
negative feedback loops

Hypothalamus

Anterior
pituitary

TSH

Thyroid

T3 + T4
Effects of Thyroid Hormone
For normal growth and development of the nervous,
skeletal, and reproductive systems

Controls the metabolism of fats, carbohydrates,

proteins and vitamins
Clinical Use: Hypothyroid States
Hormone therapy with either T3 or T4

Synthetic levothyroxine (T4) is the form of choice in

most cases
Triiodothyronine (T3) is faster acting but has a shorter
halflife and more expensive

Levothyroxine, Liothyronine, Liotrix

 Toxicity
THYROTOXICOSIS HYPOTHYROIDISM
Warm, moist skin Pale, cool skin
Sweating, heat Cold sensation
intolerance Bradycardia
Tachycardia Reduced appetite
Increased appetite Lethargy
Nervousness Weight gain
Decreased fertility
Nervousness
exopthalmos
Anti-Thyroid Drugs
Thioamides

Propylthiouracil, Methimazole

MOA: block iodination of tyrosine residues of

thyroglobulin and blockade of coupling of DIT
and MIT
 Synthesis of thyroid hormone is inhibited rather
than release
 ORAL
Useful in patients with uncomplicated
hyperthyroidism

Contraindications:
Methimazole is containdicated in pregnant and nursing
women, PTU maybe given
Toxicity:
Skin rash (common), immune eactions
Reversible effects
Iodine salts and Iodine

Lugol’s solution (iodine and potassium iodide),

saturated solution of potassium iodide

MOA: inhibition of iodination of tyrosine in

thyroid gland and thyroid hormone release

Decreases the size and vascularity of the

hyperplastic thyroid gland
Faster onset of action
Use:
Thyroid storm, severe thyrotoxicosis, preparation of
patients for surgical resection of the thyroid
Radioactive Iodine

131I – radioactive isotope

MOA: destruction of the thyroid follicle

Allows permanent cure of thyrotoxicosis

CI: pregnant and nursing women

Hashimoto’s Thyroiditis
An autoimmune disorder
which impairs the
thyroid's ability to
produce hormones

Pituitary gland attempts

to stimulate the thyroid
gland to produce more
thyroid hormones,
causing your thyroid
gland to enlarge
Graves' disease
autoimmune disorder, is
the most common cause
of an overactive thyroid
antibodies produced by
your immune system
stimulate the thyroid to
produce too much
thyroxine
Corticosteroids
 Corticosteroids
steroid hormones that are produced in the adrenal cortex.
Corticosteroids are involved in a wide range of physiologic
systems such as
stress response
immune response
regulation of inflammation
carbohydrate metabolism
protein catabolism
blood electrolyte levels
behavior
Glucocorticoids such as cortisol control carbohydrate, fat
and protein metabolism and are anti-inflammatory by
preventing phospholipid release, decreasing eosinophil
action and a number of other mechanisms

Mineralocorticoids such as aldosterone control electrolyte

and water levels, mainly by promoting sodium retention in
the kidney
Biosynthesis
Classes of corticosteroids
Group A
(short to medium acting glucocorticoids)
Hydrocortisone
Hydrocortisone acetate
Cortisone acetate
Tixocortolpivalate
Prednisolone
Methyprednisolone
Prednisone
Group B
Triamcinoloneacetonide
Triamcinolone alcohol
Mometasone
Amcinonide
Budesonide
Desonide
Fluocinonide
Fluocinoloneacetonide
Halcinonide
Group C
Betamethasone
Betamethasone sodium phosphate
Dexamethasone
Dexamethasone sodium phosphate
Fluocortolone
Group D
Hydrocortisone-17-butyrate
Hydrocortisone-17-valerate
Aclometasonedipropionate
Betamethasonevalerate
Betamethasonedipropionate
Prednicarbate
Clobetasone-17-butyrate
Clobetasol-17-propionate
Fluocortolonecaproate
Fluocortolonepivalate
Fluprednidene acetate
 Therapeutic outcomes
Glucocorticoids
Reduced pain and inflammation
Minimized shock syndrome and faster recovery
Reduced nausea and vomiting associated with chemotherapy
 Types of Corticosteroids
Topical steroidfor use topically on the skin, eye, and
mucous membranes.
Inhaled steroids for use to treat the nasal mucosa, sinuses,
bronchii, and lungs
Oral forms - such as prednisone and prednisolone.
Systemic forms - available in injectibles for use
intravenously and parenteral routes
 MINERALOCORTICOIDS
Fludrocortisone
Is an adrenal corticosteroid with potent mineralocorticoid and
glucocorticoid effects.
Affects fluid and electrolyte balance by acting on the distal
renal tubules
Used in combination with glucocorticoids to replace
mineralocorticoids activity in patients who suffer from
adrenocortical insufficiency and to treat salt-losing
adrenogenetal syndrome.
 You are THE
I am not on ANIMAL!!!!!
STEROIDS Thank you very
Much!!!!