Thyroid Disorders

Pharmacy Practice 3834 with Jerkins at Lipscomb University

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By: Joel Daniel
Created: 2012-03-27
Size: 21 flashcards
Views: 12

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Cell Types in the Thyroid

Papillary Cells – Structure

Follicular Cells – Mfr/Secrete T₄

C Cells- Mfr/Secrete Calcitonin

Describe Release and Feedback Loop for Thyroid Hormone

TRH from theHypothalamus stimulates the Pituitaryto release TSH. This stimulates the Thyroid to release T₄, whichmetabolized by end organs to T₃. T₄ and T₃ inhibitproduction of TRH in the hypothalamus.

What is revT₃

Product of conversion peripherally in states of physiologicalstress

Inactive formation

Steps of formation of T₄

Iodine Trapping

Organification

Thyroglobulin Synthesis

Coupling

Endocytosis into colloid

Proteolysis releasing T₄/T₃

Drugs that Suppress TSH

Dopamine

L-Dopa

Glucocorticoids

Drugs that Inhibit Thyroid hormone synthesis

Iodine

Lithium

Phenylbutazone^*

Sulfonylureas

*: antiinflammatory in gout/RA

Incidences that Increase TBG

Pregnancy

Increased estrogen

Cirrhosis/acute hepatitis

Congenital

Porphyria

Heroin/Methadone

Clofibrate

Incidences that Decrease TG

Protein depletion

Anabolic or HD glucocorticosteroids

Assessment of Anatomical Defects of Thyroid

Ultrasound

Nuclear scan w/ or w/o iodine

Fine Needle Aspiration

Evaluation of thyroid panels

Differentiate Primary, Secondary, and TertiaryHypothyroidism

1° - ↑TSH ↓T₄

2° - ↓TSH ↓T₄Pituitary

3° - ↓TSH ↓T₄ hypothalamus

Can no longer clinically distinguish between 2°and 3°

Most common cause of hypothyroidism

Hashimoto’s (developed world)

Iodine deficiency (third world)

Other causes of hypothyroidism

Radiation

Transient

Iodine load (Wolff Chiakoff)

Drug-Induced

Hypopituitarism

Differentiate Primary, Secondary, and Exogenous Hyperthyroidism

1° - ↑T₄/T₃ ↓TSH

2° - ↑T₄/T₃ ↑TSH

Exogenous - ↑T₄/T₃ ↓ TSH/TBG

Note: 2° is due to pituitary tumor

Note: Exogenous is due to OTC, animal thyroid, or thyroid administration

Causes of hyperthyroidism

Graves

Thyroiditis (subacute)

Iodine-induced

Amiodarone (destructive)

Interferon (autoimmune)

Toxic nodules

Pharmacologic Tx of Hyperthyroidism

Thiourea drugs

PTU

Methimazole

Lithium

Sodium idoptate

HD Steroids

SSKI

BBW for PTU

Liver damage

However, is preferred during pregnancy due to birth defectswith methimazole

What are clinical s/sx of thyroid storm?

fever, tachycardia, changed mental status, vomiting, diarrhea, cardiac arrhythmia. This is a medical emergency and this extreme hypermetabolic state is a risk of maternal heart failure.

Thyroid Cancer Types

Papillary

Follicular

Anaplastic

Medullary Carcinoma of Thyroid

Most common type of Thyroid Cancer

Papillary

Rarely spreads outside of neck

Tx of Thyroid Cancer

Total Thyroidectomy

Radiation

Suppress TSH via HD Thyroid

Drug Induced Thyroiditis

Amiodarone

Interferon

About this deck

By: Joel Daniel
Created: 2012-03-27
Size: 21 flashcards
Views: 12

About StudyBlue

“I have used this website for three exams, and I see a huge difference in my test results.”
Naj