1. THYROID HORMONES
hypothyroidism---deficiency of thyroid hormones and manifested by
slowing of all body functions.
t3--triiodothyronine
t4--tetraiodothyronine’thyroxine’
t3 & t4 for energy metabolism, critical for nervous, skeletal, reproductive
tissues.
hormone calcitonin for calcium metabolism.
the hormone molecules have much iodine in structure
infants/children symptoms---dwarfism and metal retardation, thick tongue
weight gain, puffy face, low pitch voice.
can happen with or without goiter.
adult symptoms----apathy,bradycardia, depression
thyroid hormone likely MOA----hormone binds to cell surface, allows
increased uptake of glucose and amino acids.
3. Hyperthyroidism/thyrotoxicosis (Graves disease)
tissues are exposed to excessive secretion of thyroid hormones.
pathogenesis---Likely genetic defect in suppressor T lymphocytes
yields antibody that stimulate thyroid cell.
maybe caused by excessive iodine intake, tumor, thyroid nodules.
symptoms---decreased menses, diarrhea, exopthalmos, heat
intolerance, nervousness, perspiration, tachycardia, weight loss.
reactions---fever, sore throat, unusual bleeding/bruising, headache,
malaise
hyperthyroid agents interfere with thyroid hormone production
methimazole/Tapazole
propylthiouracil/(propylthiouracil)=PTU
radioactive iodine
or thyroidectomy
4. HORMONE REPLACEMENT THERAPY
estrogen replacement therapy---
estrogens include estradiol, estrone, estriol.
deficiency yields vaginal mucosa atrophy, insomnia, irritability,
mood changes.
estrogen responsible for puberty changes, menses, blood and
skin structure, decrease rate of bone resorption, intestinal
absorption, blood coagulation, libido.
reactions----postmenopausal bleeding, nausea, breast
tenderness,
weight gain,headache
examples:
conjugated estrogen/Premarin
estradiol-levonorgestal/Climara
estradiol-norethindrone/Activella
ethinyl estradiol/Estinyl
estradiol-norgestimate/ortho-Prefest
5. PROGESTINS
progesterone is precursor to estrogens,
androgens, adrenocortical steroids.
made from cholesterol in ovary, testis, adrenal.
responsible for endometrium maturation.also
glycogen storage, increase body temperature,
increased response to CO2 ventilation,
depressant/hypnotic brain effects.
indications----menstrual dysfunction,contraception
MOA---inhibit lutenizing hormone by negative
feedback on anterior pituitary.
reactions----weight gain, depression, fatigue, acne.
examples:
levonorgestrel/Norplant
medroxyprogesterone/Provera
norethindrone/Micronor
6. oral contraceptives
normally a combination of progestin and estrogen.
MOA---supresses FSH and LH. inhibit of pituitary function, this
inhibits ovulation and changes cervical mucus, endometrium.
yields less chance for fertilization or implantation.
FSH for follicle growth. LH for ovulation and keeps
corpus luteum making estrogen and progesterone.
reactions--increased heart attack, strokes, thromboembolic
problems, depression, nausea, weight gain, breast tenderness.
consider---antibiotics may reduce contractive effectiveness.
