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甲状腺激素及抗甲状腺药Thyroidhormonesandantithyroid.ppt

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甲状腺激素(jīsù)和抗甲状腺药ThyroidhormonesandantithyroiddrugsSummary Thyroidhormones Necessarytomaintainnormalmetabolism,growthanddevelopment. Hypothyroidism CauseCretinismifithappensinembryoorneonatalperiod. Causemyxedemaifithappensinadultswhenthethyroidhormonecouldbeusedinreplacementtherapy. Hyperthyroidism Asyndromcharacterizedbythyroidoversecretionandmetabolicdisordercausedbymultiplereasons. Itcanbetreatedwithradioactiveiodine(131I)irradation,antithyroiddrugsandoperation. Thyroidhormones抗甲状腺药硫脲类Thyroidhormonesareiodicaminoacids Activecomponents Thyroxine,T4 Triiodothyreninumnatricum,T3 Chemicalconstitution甲状腺激素(jīsù)的化学结构PhysiologicaldispositionofthyroidhormonesSynthesis,storageandregulationofthyroidhormonesStepsofthyroidhormonessynthesis,releaseandregulation(Ⅰ)Condensationandstorage:Inthethyroidglobulinmolecule,twoDTTsarecondensedtoT4,oneDTTandoneMITarecondensedtoT3，whichareallstoredinglandalveoluscolloid. Disintegrationandrelease:T3andT4arereleasedintobloodafterhydrolyzedbyproteases.Atthesametime,someofthemcanbeturnedbacktotyrosineandI－bydeiodinaseincellsandreused. Regulation:Bythepositiveandnegativefeedbackregulationofhypothalamus-anteriorlobe-thyroidaxis.HypothalamussecretsTRH,anteriorlobesecretsTSHandthyroidsynthesizeT3,T4.Synthesis,storageandreleaseofthyroidhormoneThyroidhormonesMechanismofaction（figure) ItisbelievednowthatthethermogenicactionofT3andT4isduetotheincreaseofsodiumpumpsactivityonthecellmembrane.Na+,K+—ATPaseactivityATPutilizationADPconcentration mitochondriarespirationoxideconsumptionandheatproduction PhysiologicalandpharmacologicalactionsThyroidclinicalapplicationAntithyroidDrugs硫脲类ThioureaPharmacologicalactions Inhibitperoxydaseinadenocytes,whichresultsintheinhibitedoxydationofI－toI0.Then,theiodationandcoupleoftyrosinescanbestopped.SothebiosynthesisofT3andT4isinhibited.Buttheeffectoccursslowlyastheiodineuptakeandthehormonealreadysynthesizedarenoteffected. LongtimemedicationcanleadtodecreaseofT3andT4,whichfeedbackincreasesthesecretionofTSHandmakesthy