1 Antithyroid DR.dr.Asep Sukohar
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Transcript of 1 Antithyroid DR.dr.Asep Sukohar
8/20/2019 1 Antithyroid DR.dr.Asep Sukohar
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Thyroid, Antithyroid Drugs
DR.dr.Asep Sukohar,M.KesPharmacology and Therapy
Faculty of Medicine ampung !ni"ersity
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Site of action Pharmacokinetics
Pharmacodynamics Duration Of action Cost
Dosage
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Thyroid Hormonesynthesis & secretion
• Triiodothyronin (T3)• Thyroxin (T4)• Cacitonin
Secretes
• Stimuated !y TSH• "nhi!ited !y Potassium Perchorate
#$take of iodide ion
• " % "
• " ' Thyrogo!uin "T and D"T• "nhi!ited !y methimaoe & PT#
"odination
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C o n d e n s a t i o n
D"T and "T T3 and T4
"nhi!ited !yethimaoeand PT#
* e e a s e
+nter thegeneracircuation
"nhi!ited !y"odide
Stimuated
!y TSH T o a c t i n t h e t i s s u e s T
4
T 3
' " %
"nhi!ited !yPT# and β adrenergic
antagonist
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,unctions of Thyroid hormone
,aciitates norma gro-th and maturation
aintains the e.e of meta!oism• He$atic gycogenoysis ↓• gucose storage ↑• "nhi!it guconeogenesis
• "nhi!it y$oysis• Pasma amino acid ↑
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Thyroid dysfunction
• Thyroid hormone resistance & ↓TSH secretion• Hashimoto/s Thyroiditis• yxoedema
• Pituitary disease
Hy$othyroidism
• O.er$roduction of endogenous H• +x$osure to excess exogenous HHy$erthyroidism
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Drug for #ypothyroidism
e"othyro$ine • %somer T& , some are con"erted to T'
• ong half life• Steady state ( ) * + eeks• To$icity hyperthyroidism( Arrhythmia, tachycardia, anginal pain, etc.• Precautions( #eart disease
iothyronine -* Triiodothyronine sodium
• %somer T'
• //A 0 rapid1 D/A 0 shorter • R/DA( p.o, i"• %ndication(
• * se.ere hy$othyroidism• 0 1/0deiodinase deficiency2 cannot con.ert T4
• to T3
• 2% 3 AR 4e"othyro$ine
iotri$ -T' 3T&
Thyroid !SP 3 Thyroglo5ulin
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Treatment of #yperthyroidism
• Car!imaoe methimaoe$ro$ythiouraci
Thioureyenes Thionamides (56
synthesis)
• "odide $otassium $erchorate
7nion inhi!itors (56reease)
• Pro$ranoo atenoo etc89eta0 adrenoce$tor
antagonist (56 action)
• Surgica• Destruction !y radioacti.e iodine (:3:")
-hich emitted !eta $artices
*adioiodine (remo.athyroid gd8)
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%nhi5iting hormone synthesis
ethimaoe
Car!imaoe (acti.e meta!oite of
ethimaoe)
• +ffecti.eness is deayed unti stored hormoneis de$eted
• ;ot effecti.e for thyroid stormcrisis• 7d.erse effects2 agranuocytosis rash edema
Pro$ythiouraci
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6lockade #ormone release
Drugs2 "odide
Com!ined -ith PT# or ethimaoe
+ffecti.e for thyroid storm
7dministered $rior to surgery
• Decreases the .ascuarity of the gand
;ot usefu for ong0term thera$y
7d.erse reactions2
• #ceration of mucous mem!ranes• etaic taste in the mouth• rashes
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6locking the action
T3 2 acti.e form in the tissue
To act in the tissues T4 T3
•inhi!ited !y PT# and β adrenergic antagonist
β adrenergic antagonist aso normaiesheart !eat
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TH7;<S
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من بعد ول & أ% $ !" # اض من شجرة أق والحر يد
' ()*+ , ي
,- .%ا
/ % 0 .%ا
1#
23 1 د
4$ # م
أبحر
5 ع
6 789 =Dan seandainya $ohon0$ohon di !umimen>adi $ena dan autan (men>adi tinta)
ditam!ahkan ke$adanya tu>uh autan (agi)seteah (kering)nya niscaya tidak akanha!is0ha!isnya (dituiskan) kaimat0kaimat
7ah
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?#+ST"O; (+@7PA+)
7 $atient -oman 3B years od com$ain thatshe fees $a$itation after she takes a drug
-hich is used to reie.e her iness8 hich oneof this drugs that cause the -omansym$tom 78 ethimaoe
98 Ae.othyroxineC8 "odide
D8 PT#
+8 Pro$anoo
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?#+ST"O; (+@7PA+)
7 $atient -oman 3B years od com$ain thatshe fees $a$itation after she takes a drugs
-hich is used to reie.e her iness8 hich oneof this drugs that cause the -omansym$tom 78 ethimaoe
6. e"othyro$ine C8 "odide
D8 PT#
+8 Pro$anoo
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rs8 Aaia 1 years od -i has thyroidektomio$eration8 ,or decreasing the !eeding -hieo$eration a surgeon gi.es rs8 Aaia a drug$rior the o$eration8 hat is the name of thisdrug 78 ethimaoe
98 Car!imaoeC8 "odide
D8 PT#
+8 Pro$anoo
?#+ST"O; (+@7PA+)
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rs8 Aaia 1 years od -i has thyroidektomio$eration8 ,or decreasing the !eeding -hieo$eration a surgeon gi.es rs8 Aaia a drug$rior the o$eration8 hat is the name of thisdrug 78 ethimaoe
98 Car!imaoe2. %odide
D8 PT#
+8 Pro$anoo
?#+ST"O; (+@7PA+)
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rs8 ;o.i E years od com$ain that she had metaictasted in the mouth after she had taken a drug forreie.e her iness8 Since : years ago she had
hy$erthyroidism and has !een taking this drug8 hat isthe name of a drug -hich can cause her sym$tom 78 ethimaoe
98 Car!imaoe
C8 "odideD8 PT#
+8 Pro$anoo
?#+ST"O; (+@7PA+)
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hat is the drug -hich can !e used safey!y $regnant -oman in the first semester
78 Pro$itiourasi (PT#)898 ethymaoe
C8 "odide
D8 *adioacti.e iodide
+8 Thiocyanate (SC;)
?#+ST"O; (+@7PA+)
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hat is the drug -hich can !e used safey!y $regnant -oman in the first semester
A. Propiltiourasil -PT!.98 ethymaoe
C8 "odide
D8 *adioacti.e iodide
+8 Thiocyanate (SC;)
?#+ST"O; (+@7PA+)