Thyroid hormone Antithyroid drugs

Chapter 35. Diabetes mellitus, insulin, oral antidiabetes agents, obesity Chapter 36. Thyroid hormones, antithyroid drugs Chapter 37. Hypothalamic, pituitary and sex hormones Chapter 38. Vitamins, calcium, bone... 

Antithyroid dru inhibit the manufacture of thyroid hormones. They do not affect existing tiiyroid hormones tiiat are circulating in die blood or stored in die thyroid gland. For tiiis reason, therapeutic effects of the antithyroid drugs may not be observed for 3 to 4 weeks. Antithyroid drugs are listed in the Summary Drug Table Thyroid and Antithyroid Drugs. 

Other possibilities for identification (ID) of patients with thyroid disorders are searching in different records or databases, such as records of diagnoses of discharge from hospitals, prescriptions of thyroid medicaments (antithyroid drugs and levothyroxine), and records of treatments for thyroid disorders including thyroid surgery and radioiodine treatments. Finally, diagnosis of overt thyroid dysfunction is based on a biochemical thyroid function test, and laboratory databases with results of analyses of thyrotrophin (TSH) and thyroid hormones in a population cohort, and records of serum TSH in newborns may be used to identify new patients (Kempers et al., 2006). 

Thyroid hormones used in medicine include both the natural and synthetic hormones. The synthetic hormones are generally preferred because they are more uniform in potency than are the natural hormones obtained from animals. Thyroid hormones are listed in the Summary Drug Table Thyroid and Antithyroid Dragp. 

Once a euthyroid state is achieved, tlie primary health care provider may add a thyroid hormone to tlie therapeutic regimen to prevent or treat hypothyroidism, which may develop slowly during long-term antithyroid drug therapy or after administration of 131I. 

Excess production of thyroid hormone can be reduced in four ways iodides, antithyroid drugs, radioactive iodine, and... 

Some neonates born to mothers with Graves disease will be hyperthyroid at delivery. Antithyroid drug therapy (propylthiouracil 5-10 mg/kg per day or methimazole 0.5-1 mg/kg per day) may be required for up to 12 weeks. One drop per day of SSKI may be used in the first few days to rapidly reduce thyroid hormone synthesis and release. 

In patients with excess thyroid hormone production, reduce hormone production with an antithyroid drug and/or radioactive iodine. Choose therapy based on patient-specific factors and preference. 

Thyroid Hormone and Antithyroid Drugs, Pages 337-342 26.lnsulin and Synthetic Hypoglycemic Agents, Pages 343-348... 

In addition, the metabohsm of OCAs results in the release of large amounts of E into the circulation. As described for KI, I released from OCAs may have effects at the thyroid gland and if used alone to treat hyperthyroidism, OCAs carry the same potential to induce increased secretion of thyroid hormone and exacerbation of thyrotoxicosis. When an OCA is used in the treatment of hyperthyroidism, large doses of antithyroid agents are usually administered concomitantly. However, the combination of OCAs and antithyroid drugs may cause resistance to the antithyroid drugs with time, presumably because of the elevation in intrathyroidal 1 content. Thus, it is recommended that the use of OCAs be reserved for short-term treatment of patients with severe thyrotoxicosis and significant comorbidity (e.g., myocardial infarction, sepsis, stroke) for rapid control of plasma Tj concentrations. 

Chapter 37 Hypothalamic Pituitary Hormones Chapter 38 Thyroid Antithyroid Drugs... 

Bartalena L, Bogazzi F, Martino E. Adverse effects of thyroid hormone preparations and antithyroid drugs. Drug Saf 1996 15(l) 53-63. 

Treatment of metastatic differentiated thyroid cancer requires the administration of large doses of 131I (30-200 mCi) in the presence of persistently high serum levels of TSH (see Chapter 38 Thyroid Antithyroid Drugs). Patients must withdraw from thyroid hormone replacement in order to achieve this. For treatment purposes, thyrotropin alpha administration cannot substitute for thyroid hormone withdrawal. 

The main role of the human thyroid gland is production of thyroid hormones (iodinated amino acids), essential for adequate growth, development, and energy metabolism (1-6). Thyroid underfunction is an occurrence that can be treated successfully with thyroid preparations. In addition, the thyroid secretes calcitonin (also known as thyrocalcitonin), a polypeptide that lowers excessively high calcium blood levels. Thyroid hyperfunction, another important clinical entity, can be corrected by treatment with a variety of substances known as antithyroid drugs. 

Q8 The drug treatment of thyrotoxicosis involves using antithyroid drugs car-bimazole (which is converted to the active compound methimazole) and propylthiouracil inhibit the synthesis of thyroid hormone. Propylthiouracil also inhibits peripheral conversion of T4 to T3. Many of the symptoms of hyperthyroidism can also be alleviated by fl-adrenoceptor antagonists. Iodine... 

In hyperthyroidism the beneficial effects of a single dose may be felt in one month, and patients should be reviewed at 6 weeks to monitor for onset of hypothyroidism. The maximal effect of radioiodine may take 3 months. P-adrenoceptor blockade and, in severe cases, an antithyroid drug (but see footnote 1) will be needed to render the patient comfortable whilst waiting this is more likely when radioiodine is used for treatment of patients with relapsing thyrotoxicosis. Very rarely radiation thyroiditis causes excessive release of hormone and thyroid storm. Repeated doses are sometimes needed. 

Treatment of thyroiditis (Hashimoto s thyroiditis, subacute thyroiditis of de Quervain). Where hyperthyroidism is a feature, treatment is by a P-adrenoceptor blocking drug. Antithyroid drugs should not be used. Where there is permanent hypothyroidism, the treatment is thyroid hormone replacement. 

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