Anti-thyroid drug
A Thyreostatikum is a drug that the thyroid function inhibits and at an overactive thyroid gland is used.
A distinction is made between anti-thyroid drugs that inhibit the synthesis of thyroid hormones (iodination inhibitors, thiamides, such as carbimazole and its active form thiamazole , propylthiouracil ) and substances that inhibit the transport of iodine into the thyroid cells (iodination inhibitors, such as perchlorate ). In addition, high doses of iodine have an inhibitory effect on thyroid function even for a limited period of time (cf. Wolff-Chaikoff effect ).
Indications
Thyrostatic drugs are used in various forms of hyperthyroidism :
- Graves' disease : autoimmune disease, tends to spontaneous remissions, but also relapses. The treatment with thiamazole is carried out for 12 to 18 months and is intended to bridge the time until a possible remission . Therapy begins with a high initial dose, which is reduced to a maintenance dose after the euthyroid metabolic state has ceased (after about 3 to 6 weeks). The substitution of thyroxine (T4) can facilitate metabolic control. The recurrence rate is given as up to 50%; in the event of a recurrence, further treatment is carried out with radioiodine therapy or subtotal / total thyroidectomy
- Functional thyroid autonomy : areas with inadequate, autonomous secretion of thyroid hormones. In contrast to Graves' disease, spontaneous remissions are not to be expected; thyrostatic therapy aims at setting a euthyroid metabolic state in preparation for radioiodine therapy / surgery.
- Iodine-induced hyperthyroidism : if there is latent autonomy, a single dose of high-dose iodine (e.g. as part of a contrast agent for X-ray examinations) can lead to the clinical picture of hyperthyroidism. Therapy can be lengthy and involves a combination of thiamazole and perchlorate. A prophylaxis against appropriate examinations is possible with these substances.
Adverse effects of thyrostatic therapy
- Changes in the blood count ( agranulocytosis , leukopenia )
- allergic reaction
- Hypothyroidism
- Goiter
- Gastrointestinal complaints
Fattening aids
Thyreostatics were previously used in animal production as a fattening aid . Their use is prohibited in the states of the EU.
Individual evidence
- ↑ Der Spiegel, June 21, 1971, If they don't eat, I inject them myself .
- ^ Austrian Agency for Health and Food Safety AGES on "Fattening Aids" , accessed on December 1, 2015.
literature
- Kay Brune: Pharmacotherapy: Clinical Pharmacology . Springer, March 2010, ISBN 978-3-642-10540-1 , pp. 365-9 (accessed on February 25, 2012).
