Just A REVIEW on the thyroid

y Located at the base of the throat, inferior of the Adam s apple

‡Large gla

, i-l

e ,c

ecte

y a ce tral ist

us

2 hormones secreted
y Iodide containing hormones
y T3

triiodothyronine y T4 thyroxine

y Calcitonin y How do yo control it?

Synthesis of thyroid hormones
Food Thyroid follicle tyrosine

MIT, DIT Iodine s pplements 2 DIT = T4 MIT + DIT = T3

Synthesis of thyroid hormones
I

Food
Thyroid deiodinase

Thyroid follicle tyrosine
thyroglob lin

MIT, DIT Iodine s pplements 2 DIT = T4 MIT + DIT = T3

y The hypothalam s and anterior pit itary y Control the secretion of thyroid hormones thro gh two negative feedback loops

Hypothalam s

Anterior pit itary

TSH

Thyroid

¡

T3

T4

 

 

Effects of Thyroid Hormone
y For normal growth and development of the nervo s, skeletal, and reprod ctive systems y Controls the metabolism of fats, carbohydrates, proteins and vitamins

Clinical Use: Hypothyroid States
y Hormone therapy with either T3 or T4
y Synthetic levothyroxine (T4) is the form of choice in

most cases y Triiodothyronine (T3) is faster acting b t has a shorter halflife and more expensive

y Levothyroxine, Liothyronine, Liotrix

y THYROTOXICOSIS y Warm, moist skin y Sweating, heat intolerance y Tachycardia y Increased appetite y Nervo sness y Decreased fertility y Nervo sness y exopthalmos

y HYPOTHYROIDISM y Pale, cool skin y Cold sensation y Bradycardia y Red ced appetite y Lethargy y Weight gain

Anti-Thyroid Drugs
y Thioamides
y Propylthio racil, Methimazole y MOA: block iodination of tyrosine resid es of

thyroglob lin and blockade of co pling of DIT and MIT
y

Synthesis of thyroid hormone is inhibited rather than release

y ORAL y Usef l in patients with ncomplicated

hyperthyroidism
Contraindications:
y Methimazole is containdicated in pregnant and n rsing

women, PTU maybe given

Toxicity:
y Skin rash (common), imm ne eactions y Reversible effects

y Iodine salts and Iodine
y L gol s sol tion (iodine and potassi m iodide),

sat rated sol tion of potassi m iodide
y MOA: inhibition of iodination of tyrosine in

thyroid gland and thyroid hormone release
y Decreases the size and vasc larity of the

hyperplastic thyroid gland y Faster onset of action

y Use: y Thyroid storm, severe thyrotoxicosis, preparation of patients for s rgical resection of the thyroid

y Radioactive Iodine
y 131I

radioactive isotope

y MOA: destr ction of the thyroid follicle y Allows permanent c re of thyrotoxicosis y CI: pregnant and n rsing women

Hashimoto s Thyroiditis
y An a toimm ne disorder which impairs the thyroid's ability to prod ce hormones y Pit itary gland attempts to stim late the thyroid gland to prod ce more thyroid hormones, ca sing yo r thyroid gland to enlarge

Graves' disease
y a toimm ne disorder, is the most common ca se of an overactive thyroid y antibodies prod ced by yo r imm ne system stim late the thyroid to prod ce too m ch thyroxine

Corticosteroids
y steroid hormones that are prod ced in the adrenal cortex. y Corticosteroids are involved in a wide range of physiologic systems s ch as y stress response y imm ne response y reg lation of inflammation y carbohydrate metabolism y protein catabolism y blood electrolyte levels y behavior

y Glucocorticoids s ch as cortisol control carbohydrate, fat and protein metabolism and are anti-inflammatory by preventing phospholipid release, decreasing eosinophil action and a n mber of other mechanisms y Mineralocorticoids s ch as aldosterone control electrolyte and water levels, mainly by promoting sodi m retention in the kidney

Biosynthesis

Classes of corticosteroids
y Group A y (short to medi m acting gl cocorticoids) y Hydrocortisone y Hydrocortisone acetate y Cortisone acetate y Tixocortolpivalate y Prednisolone y Methyprednisolone y Prednisone

y Group B y Triamcinoloneacetonide y Triamcinolone alcohol y Mometasone y Amcinonide y B desonide y Desonide y Fl ocinonide y Fl ocinoloneacetonide y Halcinonide

y Group C y Betamethasone y Betamethasone sodi m phosphate y Dexamethasone y Dexamethasone sodi m phosphate y Fl ocortolone

y Group D
y Hydrocortisone-17-b tyrate y Hydrocortisone-17-valerate y Aclometasonedipropionate y Betamethasonevalerate y Betamethasonedipropionate y Prednicarbate y Clobetasone-17-b tyrate y Clobetasol-17-propionate y Fl ocortolonecaproate y Fl ocortolonepivalate y Fl prednidene acetate

Therapeutic outcomes
y Gl cocorticoids y Red ced pain and inflammation y Minimized shock syndrome and faster recovery y Red ced na sea and vomiting associated with chemotherapy

Types of Corticosteroids
y Topical steroidfor se topically on the skin, eye, and m co s membranes. y Inhaled steroids for se to treat the nasal m cosa, sin ses, bronchii, and l ngs y Oral forms - s ch as prednisone and prednisolone. y Systemic forms - available in injectibles for se intraveno sly and parenteral ro tes

MINERALOCORTICOIDS
y Fl drocortisone y Is an adrenal corticosteroid with potent mineralocorticoid and gl cocorticoid effects. y Affects fl id and electrolyte balance by acting on the distal renal t b les y Used in combination with gl cocorticoids to replace mineralocorticoids activity in patients who s ffer from adrenocortical ins fficiency and to treat salt-losing adrenogenetal syndrome.

I am not on STEROIDS

Yo are THE ANIMAL!!!!! Thank yo very M ch!!!!

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