1. THYROID HORMONES hypothyroidism---deficiency of thyroid hormones and manifested by slowing of all body functions. t3--triiodothyronine t4--tetraiodothyronine’thyroxine’ t3 & t4 for energy metabolism, critical for nervous, skeletal, reproductive tissues. thyroid makes hormone calcitonin for calcium metabolism. the molecules have much iodine in structure infants/children hypothyroid symptoms---dwarfism and metal retardation, thick tongue weight gain, puffy face, low pitch voice. can happen with or without goiter. adult hypothyroid symptoms----apathy,bradycardia, depression thyroid hormone likely MOA----hormone binds to cell surface, allows increased uptake of glucose and amino acids.

2. HYPOTHYROID AGENTS levothyroxine--Synthyroid liothyronine---Cytomel liotrix--Thyrolar thyroid--Armour thyroid indications----thyroid replacement therapy reactions----cardiotoxicity and hyperthyroidism consider----do TSH tests. levothyroxine injection should be quickly after reconstitution.

3. Hyperthyroidism/thyrotoxicosis (Graves disease) tissues are exposed to excessive secretion of thyroid hormones. pathogenesis---Likely genetic defect in suppressor T lymphocytes yields antibody that stimulate thyroid cell. maybe caused by excessive iodine intake, tumor, thyroid nodules. symptoms---decreased menses, diarrhea, exopthalmos, heat intolerance, nervousness, perspiration, tachycardia, weight loss. reactions---fever, sore throat, unusual bleeding/bruising, headache, malaise hyperthyroid agents interfere with thyroid hormone production treatments-- methimazole/Tapazole propylthiouracil/(propylthiouracil)=PTU radioactive iodine or thyroidectomy

4. HORMONE REPLACEMENT THERAPY estrogen replacement therapy--- estrogens include estradiol, estrone, estriol. deficiency yields vaginal mucosa atrophy, insomnia, irritability, mood changes. estrogen responsible for puberty changes, menses, blood and skin structure, decrease rate of bone resorption, intestinal absorption, blood coagulation, libido. reactions----postmenopausal bleeding, nausea, breast tenderness,weightgain,headache examples: conjugated estrogen/Premarin estradiol-levonorgestal/Climara estradiol-norethindrone/Activella ethinyl estradiol/Estinyl estradiol-norgestimate/ortho-Prefest

5. PROGESTINS progesterone is precursor to estrogens, androgens, adrenocortical steroids. made from cholesterol in ovary, testis, adrenal. responsible for endometrium maturation.also glycogen storage, increase body temperature, increased response to CO2 ventilation, depressant/hypnotic brain effects. indications----menstrual dysfunction,contraception MOA---inhibit lutenizing hormone by negative feedback on anterior pituitary. reactions----weight gain, depression, fatigue, acne. examples: levonorgestrel/Norplant medroxyprogesterone/Provera norethindrone/Micronor

6. oral contraceptives normally a combination of progestin and estrogen. MOA---supresses FSH and LH. They inhibit pituitary function, this inhibits ovulation and changes cervical mucus, endometrium. yields less chance for fertilization or implantation. FSH for follicle growth. LH for ovulation and keeps corpus luteum making estrogen and progesterone. reactions--increased heart attack, strokes, thromboembolic problems, depression, nausea, weight gain, breast tenderness. consider---antibiotics may reduce contraceptive effectiveness.

7. contraceptives examples-- ethinyl estradiol-drospirenone/Yasmin ethinyl estradiol-etonogestrel/NuvaRing ethinyl estradiol-norelgestromin/Ortho Evra ethinyl estradiol-norgestimate/Ortho tricyclen ethinyl estradiol-ethynodiol/Demulen levonorgestrel/Plan B(OTC) medroxyprogesterone/DepoProvera levonorgestrel/Norplant(not in US)