Thyroid Disease Pharmacology Quiz

Pharmacology of Thyroid Disease

• Thyroid disease includes hypothyroidism, hyperthyroidism, and nodular disease, affecting 5% to 15% of the general population, with females being affected three to four times more than males.

• The hypothalamic-pituitary-thyroid axis regulates the release of thyroid hormones, with negative feedback.

• Thyroid follicles are the functional units of the thyroid gland, containing thyroglobulin (Tg), tyrosine, iodine, thyroxine (T4), and triiodotyrosine (T3).

• T4 and T3 are synthesized through the process of iodine ingestion, uptake, oxidation, iodination of thyroglobulin, coupling of iodotyrosine residues, and proteolysis of thyroglobulin.

• T3 is four times more potent than T4, with 80% of total daily T3 production resulting from peripheral deiodination of T4.

• Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormone and can be caused by primary or secondary malfunction, with Hashimoto thyroiditis being the most common cause.

• Common causes of hypothyroidism include autoimmune disorders, surgical management, drug-induced, iodide deficiency, and postpartum thyroiditis.

• Laboratory tests for hypothyroidism include total T4, total T3, free thyroxine, TSH, and thyroid antibodies.

• Drug-induced hypothyroidism can be caused by iodine-containing contrast dyes, antineoplastic agents, propylthiouracil, iodinated glycerol, amiodarone, lithium, alpha-interferon, and anti-thyroid drugs.

• Treatment for hypothyroidism includes thyroid hormone analogs, thyroid hormone replacement, and specific dosing based on the patient's condition and medical history.

• Hyperthyroidism is the hypermetabolic syndrome resulting from excessive thyroid hormone production, with common causes including Graves' disease, toxic adenoma, toxic multinodular goiter, iodine-induced HTR, and drugs.

• Laboratory values for hyperthyroidism include both T3 and T4 being elevated, TSH being decreased, I131 uptake being increased, and TRs antibodies being increased.

• Treatment for hyperthyroidism includes radioactive iodine, surgery, beta-blockers, thioamides, and iodides, with different mechanisms of action and adverse effects.Treatment Guidelines for Thyroid Disorders

• American Thyroid Association provides guidelines for diagnosis and management of thyroid diseases during pregnancy and postpartum.

• Subclinical hypothyroidism can be treated with thyroid hormone therapy as per clinical practice guidelines.

• American Thyroid Association Task Force provides guidelines for the treatment of hypothyroidism with thyroid hormone replacement.

• Radioiodine therapy is an effective treatment for hyperthyroidism.

• American Thyroid Association provides guidelines for the diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis.

• Lugol's solution can be used as a treatment for hyperthyroidism.

• Nadolol is a beta-blocker that can be used to manage hyperthyroidism symptoms.

• Methimazole is an antithyroid medication that can be used to treat hyperthyroidism.

• PTU is another antithyroid medication that can be used to treat hyperthyroidism.

• American Thyroid Association recommends PTU as the preferred treatment for hyperthyroidism during the first trimester of pregnancy.

• American Thyroid Association recommends methimazole as the preferred treatment for hyperthyroidism during the second and third trimesters of pregnancy.

• American Thyroid Association recommends radioactive iodine therapy and surgery as the last resort for the treatment of hyperthyroidism during pregnancy.