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Glossary of Adrenals and Thyroid

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Synthetic ACTH used in therapy
Cosyntropin
Pharmokinetics of Cosyntropin
IM injection
T1/2 = 15-20mins
Initially increases cholesterol mobilization (minutes)
then code for conversion enzymes (hours-days)
Pituitary hormone that potentiates the action of CRH
Vasopressin
Use for corsyntropin
Test adrenal function
Half life of T4
Half life of T3

Half life in hypo and hyper thyroidism
6-7 days
2 days

up in hypo, down in hyper
Congenital thyroid deficiency results in?
Cretinism

Mental retardation and dwarfism
How to treat severe throtoxicosis to avoid cardiovascular colapse
Beta blockers
Thyrotropin
TSH

produced in pituitar after hypothalamic TRH stimulation
High serum T4, T3 but normal free T4 and T3
Higher throid binding globulin states (pregnancy)
Thioreylenes
Propylthiouracil
Methimazole

Inhibit synthesis of thyroid hornmones by inhibiting the peroxidase enzymes
Propylthiouracil
inhibits hepatic conversion of T4 -> T3

Better for pregnant women or breat feeders

Half life 2-3 hours
T4 -> T3 inhibitor for pregnant women
Propylthiouracil
Methimazole
inhibits hepatic conversion of T4 -> T3

Lower risk of agrangulocytosis at low dose

Half life 3-5 hours
131 Iodine
Prefered treatment for Graves disease

50-80% risk of hypothyroidism
Treatment of Graves disease
Beta blockers and thioureylene initially while waiting for 131 I to take effect
Lugols solution
inoragnic iodine + NaI

Used to prepare patient for subtotal throidectomy.

Reduces vascualrity of the gland
Used to reduce vascularity of gland
Lugols solution
Carbimazole
Pro-drug for methimazole

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