Drug



Drug |Class |MOA |Toxicity/Side Effects |Clinical Use, etc. | |

|Treatment of hypothyroidism |

| | | |Cardiovascular complications (↓these | |

|Levothyroxine sodium |T4 |Acts as endogenous T4 |w/conservative treatment.); Toxic nodular |Myxedema; Preferred over T3 for adults (longer |

|(Synthroid®) | | |goiter (hyperthyroidism) |duration, lower cost) |

| | | | |Cretinism in children – start therapy soon after |

|Liothyronine |T3 |Acts as endogenous T3 |Same as above |birth; |

| | | | |Quicker onset & better absorption than T4; also for |

| | | | |myxedema |

|Treatment of hyperthyroidism |

| | |Inhibit T3/T4 synthesis, prob. via blockade of| |Primary treatment of Grave’s disease; |

|Propylthiouracil (PTU), |Thioureylenes |peroxidase enzymes; |Agranulocytosis, bone marrow aplasia; cross|Adjunct to radioiodine treatment; |

|Methimazole | |PTU also blocks T4→T3 conversion. |placenta, secreted in milk |Used B4 thyroidectomy to prevent thyroid storm |

|Thiocyanate, |Ionic inhibitors |Completely inhibit iodide transport into |Fatal aplastic anemia |NO LONGER USED. |

|Perchlorate | |thyroid | | |

| | |High concentrations quickly prevent T3/T4 |Angioedema, hypersensitivity reactions, |Used pre-op to↓vascularity and ↑firmness of gland; |

|Iodine | |release, inhibit T3/T4 synthesis by blocking |Chronic intoxication (iodism) = burning |Useful in thyroid storm or severe thyrotoxicosis |

| | |TSH |mouth, throat, eyes, headache, cough, GI | |

| | | |irritation, skin lesions. | |

| | | |Chromosomal aberrations: contraindicated in| |

|131I | |Quickly trapped in thyroid gland, destroys |young or pregnant patients; |For hyperthyroidism: safer than surgery in |

| | |parenchymal cells preferentially. |Delayed hypothyroidism in 50% |non-pregnant patients; |

| | | | |Half-life is 8 days. |

|Propranolol |β-blocker | | |↓severe cardiac stimulation with thyroid storm |

Thyroid Drugs

Dr. Foster 4/4/02

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