药理学教学（广西医科大学）第三十三章 抗甲状腺药.pptxVIP

;Fig.1: (1)Synthesis of TH (thyroid hormone) (2) Action sites of antithyroid drugs that interfere with TH synthesis. MIT (monoiodotyrosine), DIT (diiodotyrosine), T3 (triiodothyronine) T4 (thyroxine) ;;;;Antithyroid agents;Fig.1: (1)Synthesis of TH (thyroid hormone) (2) Action sites of antithyroid drugs that interfere with TH synthesis. MIT (monoiodotyrosine), DIT (diiodotyrosine), T3 (triiodothyronine) T4 (thyroxine) ;【药理作用 pharmacolgical action】;【Action and its mechanism of thioureas】*;(2) inhibiting the conversion of peripheral T4 to T3 propylthiouracil(丙基硫氧嘧啶)抑制T4 转为T3 (3) Inhibition of immune reaction: reducing thyroid stimulating immunoglobulins for treatment of cause of hyperthyroidism 抑制免疫反应: 使甲状腺刺激性免疫球蛋白↓，对甲亢病因 (与自身免疫机制异常有关) 起一定治疗作用;Fig.1: (1)Synthesis of TH (thyroid hormone) (2)Action sites of antithyroid drugs that interfere with TH synthesis. MIT (monoiodotyrosine), DIT (diiodotyrosine), T3 (triiodothyronine) T4 (thyroxine);(2) 疗程长(1～2年)，停药过早易复发，40～70％痊愈;2. Characteristics of action:*;2. 甲亢术前准备和术后复发：术前控制甲状腺机能接近正常，以利于手术，减少并发症和死亡率。术前两周加服大剂量碘剂;(3) 合用β受体阻断剂控制交感神经功能;【Clinical uses】*;1. 粒细胞缺乏症(agranulocytosis): 本类药最严重的不良反应，发生率0.3～0.6％，一般在2～3月内，以甲基硫氧嘧啶和甲亢平为多见。;3. 甲状腺肿大(Thyromegaly)和功能减退(hypofunction)：甲状腺充血、代偿性增生肿大、变脆、功能减退。;;【Untoward Effects】*;;（5）影响胎儿和哺乳儿甲状腺功能：能透过胎盘和乳汁排出，故新生儿、妊娠、哺乳期妇女禁用;II. Iodide: potassium iodide(碘化物), sodium iodide, lugol’s(卢戈) solution;Fig.1: (1)Synthesis of TH (thyroid hormone) (2)Action sites of antithyroid drugs that interfere with TH synthesis. MIT (monoiodotyrosine), DIT (diiodotyrosine), T3 (triiodothyronine) T4 (thyroxine) ;2. large dose of Iodide*I. Inhibition of thyroid hormone release;(1) Thyroid crisis: Large dose of iodide reduce T3,T4 release (2) Preoperative preparation: Large dose of iodide reduce the size and vascularity of hyperplastic gland, and reduce bleeding of operation. It is used for 2 weeks before operation (3) Simple goiter (lack of iodide in food): Small dose of iodi