Thyroid Disease Pharmacology Quiz

Study Notes

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.