Wednesday, June 21, 2017

Classification of Drugs used in Thyroid Diseases(Pharmacological Classification of Thyroid Drugs)


Classification Of Drugs Used in Thyroid Disease
The classification of drugs used in thyroid disease in as follows :-
Classification Of Drugs Used in Thyroid Disease on the basis of Chemistry of Drugs
· Thiamides
Methimazole, carbimazole ,propylthiourea, propylthiouracil, thiouria, thiouracil,
· Anion Inhibitors
Percholate, pertechnetate, thiocyanate
· Iodides
KI,NaI
· Iodinated Contrast Media
Ipodate, Iopanoic acid
· Radioactive
Iodine-131
· NSAIDs
Aspirin
· Steroids
Corticosteroids
  • Calcium channel blockers
Diltiazem
· Beta blockers
Propanolol , atenolol
  • Adrenergic Neuron Blockers
Guanethidine, Reserpine









Classification Of Drugs Used in Thyroid Disease on the basis of mechanism of Action


Drugs inhibiting uptake of iodine

• Anion inhibitors.
e.g. perchlorate (ClO₄¯), pertechnetate (TcO₄¯) and thiocyanate (SCN¯)
These drugs block uptake of iodide through competitive inhibition of the
iodide transport mechanism.
Drugs inhibiting organification and synthesis of hormone

• Thioamides.
e.g. methimazole and propylthiouracil.
These drugs block organification of iodine and synthesis of hormone by
inhibition of peroxidase-catalyzed reactions.
• Iodides.
They inhibit organification of iodine.

Drugs inhibiting release of hormone

• Iodides.
they also inhibit hormone release and hence the availability.
• Iodinated contrast media.
e.g diatrizoate (orally) and iohexol (oral/ I.V.)
The effects of these drugs are suggestive of inhibition of hormone release.






Drugs inhibiting peripheral deiodination

• Thioamides.
e.g. propylthiouracil and methimazole (to a much lesser extent)
• Iodinated contrast media.
These inhibit peripheral deiodination (T₄ to T₃) in liver, kidney, pituitary
gland and brain.
Drugs affecting thyroid gland integrity

• Iodides.
These decrease the size and vascularity of a hyperplastic gland.
• Radioactive iodine
Only isotope ¹³¹I .
It destroys the gland parenchyma.


Drugs countering sympathetic stimulation

• Adrenoceptor-blocking agents.
e.g. beta blockers without intrinsic sympathomimetic activity such as
metoprolol, propranolo, atenolol).
They are for the symptomatic treatment.














Classification Of Drugs Used in Thyroid Disease on the basis of site of action

Drugs acting on thyroid gland

Drugs acting on thyroid peroxidase
Thioamides.
e.g. methimazole, propylthiouracil, propylthiourea, thiourea, thiouracil
Drugs acting on thyroglobulin
Iodides.
Drugs acting on thyroid follicles
Radioactive iodine-131
Drugs acting on thyroid vascularity
Iodides

Drugs acting on iodide uptake mechanism
Anion inhibitors
e.g. percholate, pertechanate, thiocyanate
Drugs acting on Beta adrenoceptors
Adrenoceptor blocking drugs
e.g. propranolol, metoprolol, atenolol
Drugs acting on calcium channel blockers
Dilitazem













Drugs acting on adrenergic neurons
Guanithidine, reserpine
Drugs acting peripherally
Diatrizoate, Iohexol, methimazole, propylthiouracil



























THERAPEUTIC CLASSIFICATION Of Drugs Used in Thyroid Disease

· Drugs used in Thyrotoxicosis
Metimazole
Propylthiouracil
Carbmezole
Diltizem
· Drugs Used in thyroid disease of pregnancy
Propylthiouracil with a thyroid supplement
· Drugs Used in Neonatal grave`s disease
Propylthiouracil
Lugol`s solution
Propanalol
Prednisone
· Amiodranone induced thyrotoxiosis
Thiomides with carbmezole
Thiourea thiouracil
· Drugs used in Toxic uninodular/ multinodular goiter
Drugs for uninodular goiter
Radio iodine therapy [before surgical incision]
Drugs For multinodular goiter
Methimazole
Propylthiouracil
· Subacute thyroiditis
Propanalol
Aspirin
Nsaids ,corticosteroids
·Drugs used in  Preoperative preparation for thyroidectomy and iodine deficiency goiter
KI
NaI
· Special problems
Drugs used in Thyroid storms
Propanalol
Diltiazem
KI
Propylthiouracil
Hydrocortisone
methimazole
Drugs Used in Ophthalmopathy
Prednisone therapy
High energy x-ray therapy
· Non toxic goiter
Drugs used in Iodine deficiency
Prophylactic administration of iodine
Iodized salt
Iodate preservative
Iodized poppy seed oil
Drugs for treatment of  injestion of goitrogens and in dyshormonogenesis and in hashimoto`s thyroiditis
Thyroxine therapy
· postoperative thyroid neoplasms
Levothyroxine
Radio iodine therapy
Recombinant human TSH

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