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



Site of action Pharmacokinetics

Pharmacodynamics Duration Of action Cost

Dosage



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



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



,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 ↑



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



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



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)



%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



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



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



TH7;<S



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



?#+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



?#+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



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+)



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+)



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+)



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+)



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+)

1 antithyroid dr.dr.asep sukohar

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