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甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs甲状腺激素和抗甲状腺药Thyroidhormonesanda1ThyroidhormonesandantithyroiddrugsSummaryThyroidhormones
Necessarytomaintainnormalmetabolism,growthanddevelopment.Hypothyroidism
CauseCretinismifithappensinembryoorneonatal
period.Causemyxedemaifithappensinadultswhenthethyroidhormonecouldbeusedinreplacementtherapy.Hyperthyroidism
Asyndromcharacterizedbythyroidoversecretionandmetabolicdisordercausedbymultiplereasons.Itcanbetreatedwithradioactiveiodine(131I)irradation,antithyroiddrugsandoperation.Thyroidhormonesandantithyro2最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件3最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件4最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件5最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件6最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件7最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件8Synthesis,storageandregulationofthyroidhormonesIodineuptakeIodineactivationandtyrosineiodationCondensationandstorageDisintegrationandreleaseRegulationSynthesis,storageandregula9Stepsofthyroidhormonessynthesis,releaseandregulationIodineuptake:I-inbloodcanbeuptakenintocellsbyiodinepumpintheadenocytemembrane.Theaminoacidscanbeusedtosynthesizethyroidglobulinincells.Iodineactivationandtyrosineiodation:I-uptakenintocellscanbeoxydizedtoactiveiodinebyperoxydase.ActiveiodinebindstotyrosineofTGandformsmonoiodotyrosine(MIT)and
diiodotyrosine(DTT).Stepsofthyroidhormonessynt10Stepsofthyroidhormonessynthesis,releaseandregulationCondensationandstorage:Inthethyroidglobulinmolecule,twoDTTsarecondensedtoT4,oneDTTandoneMITarecondensedtoT3,whichareallstoredinglandalveoluscolloid.Disintegrationandrelease:T3andT4arereleasedintobloodafterhydrolyzedbyproteases.Atthesametime,someofthemcanbeturnedbacktotyrosineandI-bydeiodinaseincellsandreused.Regulation:Bythepositiveandnegativefeedbackregulationofhypothalamus-anteriorlobe-thyroidaxis.HypothalamussecretsTRH,anteriorlobesecretsTSHandthyroidsynthesizeT3,T4.Stepsofthyroidhormonessynt11synthesis,storageandreleaseofthyroidhormone
GastrointestinalI-Blood
I-I-Peroxid-aseIoTGTyrIodat-ionMITDITCon-den-sationMIT+DITDIT+DITT3T4TGAcinarluminaStorageSynthesisReleaseActivationProteaseT3T4MIT一碘酪氨酸DIT二碘酪氨酸TG甲状腺球蛋白血液synthesis,storageandreleas12ThyroidhormonesMechanismofactionThebindingofT3andRincreasestheuptakeofaaandglucose,resultingintheentrancetocytoplasmofT3.AfterreactingwithCBP,T3iseduced.ThefreeT3canbindRinthemitochondriaandmakeADPtoATP.Besides,itcanenterthenuclearandbindRthere,whichcanincreasethetranscriptionofDNAandthecontentofmRNA.Thenthenewproteinscanbesynthesizedandplayroles.ThyroidhormonesMechanismofa13Thyroidhormones作用机理(图示)ItisbelievednowthatthethermogenicactionofT3andT4isduetotheincreaseofsodiumpumpsactivityonthecellmembrane.Na+,K+—ATPaseactivityATPutilizationADPconcentrationmitochondriarespirationoxideconsumptionandheatproductionThyroidhormones作用机理(图示)14Physiologicalandpharmacologicalactions
KeepnormalgrowthanddevelopmentPromotesynthesisofproteinsaswellasgrowthanddevelopmentofskeletonandCNS.T3,T4deficientsecretion:causescretinismininfantsandyoungchildrenandmucousedemainadults.
PromotemetabolismandincreaseheatproductionPromoteoxidation,increaseoxygenconsumption,basalmetabolicrateandheatproduction.
Elevatesensitivityofsympathetic-adrenalsystem
Nervousness,trembling,heartbeatspeedup,bloodpressureincreasePhysiologicalandpharmacologi15ThyroidclinicalapplicationReplacementtherapymainlyTherapyanddiagnosisapplication
Cretinism
Treatingtheinfantsandchildrenassoonaspossiblecouldcurethemtonormal.Iftreatingtoolate,theyneedtobetreatedalifetime.
MucousedemaIncreasethedosageofthyroidpalletgradually.Toolargedosagemayaggravateheartdiseases.Patientsincomashouldbegivenafistaid,whichisinfusionofT3(40-120μg)intravenoiusly,reinjection5-15μgevery6handoraladministrationwhenawake.Hypopituitarismpatientsshouldbegivencorticalhormonefirstandfollowedbythyroidhormone.Simplegoiter ReplacementtherapycaninhibitTSHoversecretionandcontracttheglandularorgan,3-6months.T3inhibitiontestDifferentialdiagnosisforPatientswithiodinehighuptake.
ThyroidclinicalapplicationRe16AdverseeffectsadverseeffectoverdosecombinationcontraindicationhyperthyreosisoldpeopleheartdiseasebishydroxycoumarindantinaoraspirindiabeteshypertensionCoronaryheartdiseasepyknocardiathyroidcrisis:anxiety,fear,restlessness,highbodytemperature,increaseandirregularheartrate,increasepulsepressure,congestiveheartfailurewithvomit,diarrheaanddehydrationwhichleadtocomaanddeathAnginaorheartinfarctionIncreasetoxicityofthyroidhormoneAdverseeffectsadverseeffec17AntithyroidDrugsTherapiesofhyperthyrosisinclude131Iradiotherapy,exairesisormedication.Thioureahomologuesaremainlyusedclinically.Iodineandiodideareusedjustinpreparationforoperationsandthyroidcrisistherapy.βreceptorblockerscanbeusedasadjunctivetherapyforthyroidcrisis.AntithyroidDrugsTherapiesof18硫脲类(Thiourea)硫氧嘧啶类(thiouracil):甲基硫氧嘧啶(methykthiouracil)丙基硫氧嘧啶(propylthiouracil)咪唑类(imidazoles):他巴唑(Tapazole),甲巯咪唑(methimazole)甲亢平(卡比马唑Carbimazole)硫脲类(Thiourea)硫氧嘧啶类(thiouracil)19ThioureaPhysiologicalprocessAbsorption:easytobeabsorbedwhentakenorally.Thiouracilisthemostfasttobeabsorbed.Thebioavailabilityis80%andtheplasmaproteinbindingrateis75%.20-30minafteradministration,thedrugturnstobecomeeffectivewithT1/2of2h.Imidazoleisabsorbedslowly.T1/2oftapazoleis6h.Distribution:organsgenerallyalloverthebodyandcanpasstheplacenta.Theconcentrationinlactoisabout3timesasinblood.Metabolism:Mainlyinliver,fast.60%aredestroyedinvivo,therestareeliminatedbyurineinaconjugativeform.Carbimazolefunctionsafterturningintotapazoleinvivo.ThioureaPhysiologicalprocess20ThioureaPharmacologicalactionsInhibitperoxydaseinadenocytes,whichresultsintheinhibitedoxydationofI-toI0.Then,theiodationandcoupleoftyrosinescanbestopped.SothebiosynthesisofT3andT4isinhibited.Buttheeffectoccursslowlyastheiodineuptakeandthehormonealreadysynthesizedarenoteffected.LongtimemedicationcanleadtodecreaseofT3andT4,whichfeedbackincreasesthesecretionofTSHandmakesthyroidhyperplasyandhyperemiccompensatorily.PropylthiouracilcaninhibitT4turningtoT3andcontrolT3levelinblood.Soitisthefirstchoiceinhyperthyroidismcrisis,severehyperthyroidismandpregnanthyperthyroidism.Inhibitimmuno-system(ashyperthyroidismisrelatedwithabnormalimmunoreactions).ThioureaPharmacologicalaction21EtiopathogenesisofExophthalmoshyperthyroidism
andfunctionlinkofthioureahomologuesThisdiseaseiscausedbyanautoimmuneIgGantibodyLATS(longactingthyroidstimulator),whichcanbindtothereceptorsonthyroidadenocytesandstimulateoversecretionofthyroidhormones.Thioureahomologuescannotonlyinhibitsynthesisofthyroidhormones,butalsoLATSinpatients,whichisakindofimmunoinhibition.EtiopathogenesisofExophthalm22ThioureaClinicalapplicationHyperthyroidismForwhohasmildsymptomsandisnotsuitabletohaveoperationsand131Iradiotherapy.GiveLargerdoseatthebeginning.After1~3months,symtomsdecreasedandbasalmetabolicratereturnstoalmostnormal.Reducetomaintainingdosewithaperoidof1~2years.Alsocanbeusedasadjunctivetherapyof131Iradiotherapy.Preparationbeforeoperation:Medicationbeforeoperationisgoodtodecreasebleedinginoperationandpreventthyroidcrisisafteroperation.Adjunctivemedicationofthyroidcrisis:Besidesintegratemeasures,largedoseofThioureahomologuescanbeusedasadjunctivetherapy,SoisPropranolol.ThioureaClinicalapplication23Comparisonamongcommonthioureahomologuesdrugs
drugpotency
therapeuticdosemaintenanceadverseeffects
agranulemia (mg/d) doseincidence(%)incidence(%)
mildmoderatesevere
(mg/d)
Methyl 1 200-300 400-600 13.8 0.5 thiouracil 300-400 50-100Propyl 0.75 3.3 0.4thiouracilTapazole10 20-30 40-60 7.1 0.1Carbimazole10 30-40 5-10 1.9 0.8Comparisonamongcommonthiou24ThioureaAdverseeffects
Althoughtherearelotsofadverseeffectsofthioureahomologues,incidencesofpropylthiouracilandtapazolearelower,3%and7%respectively.Commonadverseeffects:
skinrash,headache,dinus,gastrointestinaluncomfortable,fatigueandsoon.
Severeadverseeffects:bonemarrowdepression,agranulocytosisandsoon.Note:periodicinspectionofhemogram.Themedicationshoulebestoppedifthesymptomsaspharyngalgia,fever,cathaeresisoccur.Thyroidcancerpatientsareforbiddentotake.ThioureaAdverseeffects25IodineandiodideActionsandapplicationsLowdoseofiodine(physiologicaldose)couldpreventandcuresimple(endemicity)goiter.Add1/10000~1/100000potassiumiodideorsodiumiodidetosaltcouldpreventthedesease.LargedoseofiodinecouldinhibitthereleaseofT3andT4(duetotheinhibitionofTGhydratase).Usedasadjunctivetherapyforhyperthyroidism:①preparationbeforeoperation:administrationofaqueousiodinesolutiontwoweeksbeforeoperationdegeneratestheglandulartissue,decreasesvesselsandbleeding;②adjunctivetherapyforthyroidcrisis:couldbeusedcombinedwiththioureahomologues.IodineandiodideActionsanda26IodineandiodideAdverseeffectsandapplicationnotes
Acuteeffects:acutecircumscribededema,laryngealedemaandapnoeaChronictoxicity:mouthandthroatburningsensation,increasesecretionofsalivary,eyeirritationandsoon.
Inducedysthyroidandhyperthyroidismafterlongmedication.Iodinecouldpassintothemilkandthroughplacenta,leadingtoneonatgoiter.Pregnantandlactantwomenshouletakethedrugwithcausious.Allergicandactivetuberculosispatientsareforbiddentotake.IodineandiodideAdverseeffe27Radioactiveiodine(131I)
T1/2is8.04daysActions
131Icouldbeuptakenbythroid,participateinthesynthesisofT3,T4andisstoredinfollecularcolloid.131Imainlygeneratesβray(99%)withaverageandmaximumpathof0.5mmand2mmrespectively.Sotheirradiationfunctionislimitedinthethyroid.Itcandestroytheglandularorganbutcanseldomdestroythesurroundingtissues.Γraygeneratedby131Iaccountsfor1%andcanbedetectedinvitro.Itisusuallyusedintheexaminationofthyroidiodineuptakingfunction.Radioactiveiodine(131I)
T28Radioactiveiodine(131I)ClinicalapplicationThyroidiodineuptakefunctionexamination:iodineuptakeratehighwhenhyperthyroid,timeofiodineuptakepeakantelocationiodineuptakeratelowwhenhypothyroid,timeofiodineuptakepeakretropositionHyperthyroidismTraceamountcouldbeusedindiagnosisofthyroidfunctionalstatusandthyroidadenoma.Radioactiveiodine(131I)Clinic29放射性碘(131I)
AdverseeffectsandapplicationnotesHypothyroidismisthepredominantcomplication.Theadverseeffectscanbereducedbystrictdosecontrolandresistedbythyrine.PatientswithTotalwhitebloodcellslessthan3000/mm3arenotsuitabletotakeit.Soarepragnantandlactantwomen,patientsyoungerthan20yearsoldorwithsevereliverorkidneydeseases.
放射性碘(131I)Adverseeffectsand30receptorblockersValuableadjunctivetherapydrugsforhyperthyroidismandthyroidcrisis.Theycouldimprovesymptomscausedbyaugmentedsympatheticactivitysuchasspeedupheartrateandincreaseheartcontractionforce.TheycanalsoreducethethyroidhormonesecretionandT3synthesisbyinhibiting5`-deiodinase.Controlhyperthyroidismsymptomsandcanbeusedinpreparationbeforeoperation.receptorblockersValuablead31receptorblockersClinicalapplicationAdjunctivetherapyforhyperthyroidismandhyperthyroidismcrisis.MechanismofpharmacologicalactionsControlsymptomscausedbyexcitedsympathetic-adrenergicsystemβ1receptorblockage-heartratedropCentralβreceptorblockage-toreduceanxietyβ2receptoronNAenerginicperipheralnerveendingspresynapticmembraneblockagereducesthereleaseofNA.AppropriatelyreduceT3,T4secretion.receptorblockersClinicalap32Thanks!Thanks!33
结束语谢谢大家聆听!!!34
结束语谢谢大家聆听!!!34甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs甲状腺激素和抗甲状腺药Thyroidhormonesanda35ThyroidhormonesandantithyroiddrugsSummaryThyroidhormones
Necessarytomaintainnormalmetabolism,growthanddevelopment.Hypothyroidism
CauseCretinismifithappensinembryoorneonatal
period.Causemyxedemaifithappensinadultswhenthethyroidhormonecouldbeusedinreplacementtherapy.Hyperthyroidism
Asyndromcharacterizedbythyroidoversecretionandmetabolicdisordercausedbymultiplereasons.Itcanbetreatedwithradioactiveiodine(131I)irradation,antithyroiddrugsandoperation.Thyroidhormonesandantithyro36最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件37最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件38最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件39最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件40最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件41最新甲状腺激素和抗甲状腺药Thyroidhormonesandantithyroiddrugs课件42Synthesis,storageandregulationofthyroidhormonesIodineuptakeIodineactivationandtyrosineiodationCondensationandstorageDisintegrationandreleaseRegulationSynthesis,storageandregula43Stepsofthyroidhormonessynthesis,releaseandregulationIodineuptake:I-inbloodcanbeuptakenintocellsbyiodinepumpintheadenocytemembrane.Theaminoacidscanbeusedtosynthesizethyroidglobulinincells.Iodineactivationandtyrosineiodation:I-uptakenintocellscanbeoxydizedtoactiveiodinebyperoxydase.ActiveiodinebindstotyrosineofTGandformsmonoiodotyrosine(MIT)and
diiodotyrosine(DTT).Stepsofthyroidhormonessynt44Stepsofthyroidhormonessynthesis,releaseandregulationCondensationandstorage:Inthethyroidglobulinmolecule,twoDTTsarecondensedtoT4,oneDTTandoneMITarecondensedtoT3,whichareallstoredinglandalveoluscolloid.Disintegrationandrelease:T3andT4arereleasedintobloodafterhydrolyzedbyproteases.Atthesametime,someofthemcanbeturnedbacktotyrosineandI-bydeiodinaseincellsandreused.Regulation:Bythepositiveandnegativefeedbackregulationofhypothalamus-anteriorlobe-thyroidaxis.HypothalamussecretsTRH,anteriorlobesecretsTSHandthyroidsynthesizeT3,T4.Stepsofthyroidhormonessynt45synthesis,storageandreleaseofthyroidhormone
GastrointestinalI-Blood
I-I-Peroxid-aseIoTGTyrIodat-ionMITDITCon-den-sationMIT+DITDIT+DITT3T4TGAcinarluminaStorageSynthesisReleaseActivationProteaseT3T4MIT一碘酪氨酸DIT二碘酪氨酸TG甲状腺球蛋白血液synthesis,storageandreleas46ThyroidhormonesMechanismofactionThebindingofT3andRincreasestheuptakeofaaandglucose,resultingintheentrancetocytoplasmofT3.AfterreactingwithCBP,T3iseduced.ThefreeT3canbindRinthemitochondriaandmakeADPtoATP.Besides,itcanenterthenuclearandbindRthere,whichcanincreasethetranscriptionofDNAandthecontentofmRNA.Thenthenewproteinscanbesynthesizedandplayroles.ThyroidhormonesMechanismofa47Thyroidhormones作用机理(图示)ItisbelievednowthatthethermogenicactionofT3andT4isduetotheincreaseofsodiumpumpsactivityonthecellmembrane.Na+,K+—ATPaseactivityATPutilizationADPconcentrationmitochondriarespirationoxideconsumptionandheatproductionThyroidhormones作用机理(图示)48Physiologicalandpharmacologicalactions
KeepnormalgrowthanddevelopmentPromotesynthesisofproteinsaswellasgrowthanddevelopmentofskeletonandCNS.T3,T4deficientsecretion:causescretinismininfantsandyoungchildrenandmucousedemainadults.
PromotemetabolismandincreaseheatproductionPromoteoxidation,increaseoxygenconsumption,basalmetabolicrateandheatproduction.
Elevatesensitivityofsympathetic-adrenalsystem
Nervousness,trembling,heartbeatspeedup,bloodpressureincreasePhysiologicalandpharmacologi49ThyroidclinicalapplicationReplacementtherapymainlyTherapyanddiagnosisapplication
Cretinism
Treatingtheinfantsandchildrenassoonaspossiblecouldcurethemtonormal.Iftreatingtoolate,theyneedtobetreatedalifetime.
MucousedemaIncreasethedosageofthyroidpalletgradually.Toolargedosagemayaggravateheartdiseases.Patientsincomashouldbegivenafistaid,whichisinfusionofT3(40-120μg)intravenoiusly,reinjection5-15μgevery6handoraladministrationwhenawake.Hypopituitarismpatientsshouldbegivencorticalhormonefirstandfollowedbythyroidhormone.Simplegoiter ReplacementtherapycaninhibitTSHoversecretionandcontracttheglandularorgan,3-6months.T3inhibitiontestDifferentialdiagnosisforPatientswithiodinehighuptake.
ThyroidclinicalapplicationRe50AdverseeffectsadverseeffectoverdosecombinationcontraindicationhyperthyreosisoldpeopleheartdiseasebishydroxycoumarindantinaoraspirindiabeteshypertensionCoronaryheartdiseasepyknocardiathyroidcrisis:anxiety,fear,restlessness,highbodytemperature,increaseandirregularheartrate,increasepulsepressure,congestiveheartfailurewithvomit,diarrheaanddehydrationwhichleadtocomaanddeathAnginaorheartinfarctionIncreasetoxicityofthyroidhormoneAdverseeffectsadverseeffec51AntithyroidDrugsTherapiesofhyperthyrosisinclude131Iradiotherapy,exairesisormedication.Thioureahomologuesaremainlyusedclinically.Iodineandiodideareusedjustinpreparationforoperationsandthyroidcrisistherapy.βreceptorblockerscanbeusedasadjunctivetherapyforthyroidcrisis.AntithyroidDrugsTherapiesof52硫脲类(Thiourea)硫氧嘧啶类(thiouracil):甲基硫氧嘧啶(methykthiouracil)丙基硫氧嘧啶(propylthiouracil)咪唑类(imidazoles):他巴唑(Tapazole),甲巯咪唑(methimazole)甲亢平(卡比马唑Carbimazole)硫脲类(Thiourea)硫氧嘧啶类(thiouracil)53ThioureaPhysiologicalprocessAbsorption:easytobeabsorbedwhentakenorally.Thiouracilisthemostfasttobeabsorbed.Thebioavailabilityis80%andtheplasmaproteinbindingrateis75%.20-30minafteradministration,thedrugturnstobecomeeffectivewithT1/2of2h.Imidazoleisabsorbedslowly.T1/2oftapazoleis6h.Distribution:organsgenerallyalloverthebodyandcanpasstheplacenta.Theconcentrationinlactoisabout3timesasinblood.Metabolism:Mainlyinliver,fast.60%aredestroyedinvivo,therestareeliminatedbyurineinaconjugativeform.Carbimazolefunctionsafterturningintotapazoleinvivo.ThioureaPhysiologicalprocess54ThioureaPharmacologicalactionsInhibitperoxydaseinadenocytes,whichresultsintheinhibitedoxydationofI-toI0.Then,theiodationandcoupleoftyrosinescanbestopped.SothebiosynthesisofT3andT4isinhibited.Buttheeffectoccursslowlyastheiodineuptakeandthehormonealreadysynthesizedarenoteffected.LongtimemedicationcanleadtodecreaseofT3andT4,whichfeedbackincreasesthesecretionofTSHandmakesthyroidhyperplasyandhyperemiccompensatorily.PropylthiouracilcaninhibitT4turningtoT3andcontrolT3levelinblood.Soitisthefirstchoiceinhyperthyroidismcrisis,severehyperthyroidismandpregnanthyperthyroidism.Inhibitimmuno-system(ashyperthyroidismisrelatedwithabnormalimmunoreactions).ThioureaPharmacologicalaction55EtiopathogenesisofExophthalmoshyperthyroidism
andfunctionlinkofthioureahomologuesThisdiseaseiscausedbyanautoimmuneIgGantibodyLATS(longactingthyroidstimulator),whichcanbindtothereceptorsonthyroidadenocytesandstimulateoversecretionofthyroidhormones.Thioureahomologuescannotonlyinhibitsynthesisofthyroidhormones,butalsoLATSinpatients,whichisakindofimmunoinhibition.EtiopathogenesisofExophthalm56ThioureaClinicalapplicationHyperthyroidismForwhohasmildsymptomsandisnotsuitabletohaveoperationsand131Iradiotherapy.GiveLargerdoseatthebeginning.After1~3months,symtomsdecreasedandbasalmetabolicratereturnstoalmostnormal.Reducetomaintainingdosewithaperoidof1~2years.Alsocanbeusedasadjunctivetherapyof131Iradiotherapy.Preparationbeforeoperation:Medicationbeforeoperationisgoodtodecreasebleedinginoperationandpreventthyroidcrisisafteroperation.Adjunctivemedicationofthyroidcrisis:Besidesintegratemeasures,largedoseofThioureahomologuescanbeusedasadjunctivetherapy,SoisPropranolol.ThioureaClinicalapplication57Comparisonamongcommonthioureahomologuesdrugs
drugpotency
therapeuticdosemaintenanceadverseeffects
agranulemia (mg/d) doseincidence(%)incidence(%)
mildmoderatesevere
(mg/d)
Methyl 1 200-300 400-600 13.8 0.5 thiouracil 300-400 50-100Propyl 0.75 3.3 0.4thiouracilTapazole10 20-30 40-60 7.1 0.1Carbimazole10 30-40 5-10 1.9 0.8Comparisonamongcommonthiou58ThioureaAdverseeffects
Althoughtherearelotsofadverseeffectsofthioureahomologues,incidencesofpropylthiouracilandtapazolearelower,3%and7%respectively.Commonadverseeffects:
skinrash,headache,dinus,gastrointestinaluncomfortable,fatigueandsoon.
Severeadverseeffects:bonemarrowdepression,agranulocytosisandsoon.Note:periodicinspectionofhemogram.Themedicationshoulebestoppedifthesymptomsaspharyngalgia,fever,cathaeresisoccur.Thyroidcancerpatientsareforbiddentotake.ThioureaAdverseeffects59IodineandiodideActionsandapplicationsLowdoseofiodine(physiologicaldose)couldpreventandcuresimple(endemicity)goiter.Add1/10000~1/100000potassiumiodideorsodiumiodidetosaltcouldpreventthedesease.LargedoseofiodinecouldinhibitthereleaseofT3andT4(duetotheinhibitionofTGhydratase).Usedasadjunctivetherapyforhyperthyroidism:①preparationbeforeoperation:administrationofaqueousiodinesolutiontwoweeksbeforeoperationdegeneratestheglandulartissue,decreasesvesselsandbleeding;②adjunctivetherapyforthyroidcrisis:couldbeusedcombinedwiththioureahomologues.IodineandiodideActionsanda60IodineandiodideAdverseeffectsandapplicationnotes
Acuteeffects:acutecircumscribededema,laryngealedemaandapnoeaChronictoxicity:mouthandthroatburningsensation,increasesecretionofsalivary,
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