Introduction et al. (2014), the treatment of thyroid

Introduction

The thyroid gland is found in the
anterior region of the neck having its main secretions as T3 and T4 hormones.
The two hormones act as metabolic regulators in the body. The functions of this
gland are regulated by the pituitary gland in the brain through feedback system.  The hormone secreted by the pituitary for that
purpose is thyroid stimulating hormone (Brent, 2012). 
Therefore, the thyroid is an important organ in the body whose dysfunction
often lead to serious morbidity and, therefore, proper management is paramount.

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Background

According to Ross et al., (2016), diseases
that affect the thyroid can be classified as either primary or secondary depending
on whether is intrinsically thyroid or not. Diseases symptoms can range from
debilitating to sub-clinical to asymptomatic and each can result in either an
increase in the serum levels of thyroid hormones (Hyperthyroidism) or decrease
in levels of the thyroid hormones referred to as hypothyroidism. Both these clinical
states manifest with differing symptomatology such as unintentional weight
loss, abnormal sweating, intolerance to heat and problems with the eyes among
others for hyperthyroidism, while hypothyroidism manifest as unintended gaining
of weight, intolerance to cold and myxedema among others. Examples of pathologies
that affect  the thyroid gland include
grave’s disease, thyroiditis, tumors, auto-immune conditions like hashimoto’s
thyroiditis according to, iodine deficiencies etc. (Stathatos & Daniels, 2012).

Drugs
used in Treatment of Symptoms

As stipulated by Jonklaas et al. (2014),
the treatment of thyroid diseases is dependent on the specific etiology and the
clinical signs apparent on the patient and range from surgical, medical and
conservative in sub-clinical cases. Examples of drugs used in the treatment and
management of Hyperthyroidism are anti-thyroid drugs such as methimazole, Carbimazole
and propylthiouracil which are started at high doses. These can help achieve
euthyroid states within 14 days of use. Beta-blockers like propranolol are also
used to control the excessive metabolic symptoms. Other drug options include
oral radioactive iodide that is absorbed by the thyroid gland and results in
down-regulation of thyroid hormone synthesis. Hypothyroidism that due is to
iodine deficiency is managed by giving iodine supplements either in food or in
tablets. Levothyroxine is a T4 analogue used to raise the levels of serum thyroid
hormone to baseline in cases of hypothyroidism.

Other causes of thyroid dysfunction are
immune mediated like hashimoto’s while others are due to infections that cause
inflammation of the thyroid gland such as thyroiditis. These can be treated
with non-steroidal anti-inflammatory drugs (NSAIDs) or levothyroxine or corticosteroids
like prednisolone to reduce thyroid inflammation.

Effects
of age on thyroid Medications

The pharmacodynamics and pharmacokinetics
of drugs are affected by patients’ ages and as such, for the extreme
age-groups, there exists differences in the rates of elimination, drug metabolism,
and compositions of body which might affect the bioavailability, duration of
action, the route and methods of administration and even the dosages used,
which alternatively affects the workings of drugs in those groups. The drugs
that are majorly eliminated via the kidneys take longer in the bloodstream if
the renal system is impaired in any way such as in the elderly. The result is
an enhancement in the magnitudes of side effects and prolongation of their
durations of action. In addition, the elderly have reduced body water and as
such, some drugs would therefore be administered differently, which will
directly or indirectly have an impact on bioavailability.

Reducing
Side Effects of Drugs

As with any other drug, drugs used in
the treatment of thyroid disease also do have side-effects. Corticosteroids which
are used in the management of autoimmune thyroid disease have side effects on
almost all systems in the body. They include but not limited to osteoporosis,
hypertension, gastrointestinal symptoms and increased susceptibility to
infections (Pandya,
Puttanna, & Balagopal, 2014). The commonest
side-effects of the anti-thyroid drugs is a rash that always resolve upon drug withdrawal.
Propylthiouracil also has a small risk for hepatotoxicity and as such, liver
function tests are necessary to ensure it is not damaged. Methimazole can cause
aplastic anemia and thrombocytopenia; reducing this effect involves doing full
blood counts to identify problems with the marrow as soon as possible. Other
side effects of these drugs like headaches and upset of the gastrointestinal system
can be managed by educating the patients on the expected effects and advising
them to visit a hospital if the side effects persist or become worse..

Conclusively, it is important to educate
the patient on the possible side effects of the drugs given and advise them to
seek immediate medical help in case of any unusual symptoms. Thyroid diseases are
chronic and require cooperation between the health care provider and the
patient if proper and adequate remission is to be expected.