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Endocrine Drugs: Thyroid Agents

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Thyrotropin alfa

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Indications: Thyroid cancer surveillance. Effects: Recombinant TSH, used in conjunction with radioactive iodine imaging to detect thyroid tissue without stopping thyroid hormone therapy.

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Cabergoline

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Indications: Hyperprolactinemia, Parkinson's disease. Effects: Dopamine agonist that inhibits pituitary lactotroph cells, indirectly affecting thyroid hormone regulation.

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Radioactive iodine-131

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Indications: Hyperthyroidism, Thyroid cancer. Effects: Absorbed by thyroid and destroys thyroid tissue, reducing hormone production.

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Liothyronine

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Indications: Hypothyroidism, T3 replacement. Effects: Synthetic form of triiodothyronine (T3), increases metabolic rate and heart rate.

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Potassium iodide

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Indications: Preparation for thyroidectomy in Graves' disease, Thyroid storm. Effects: High doses block release of thyroid hormone (Wolff-Chaikoff effect), reduces vascularity of the thyroid gland.

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Methimazole

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Indications: Hyperthyroidism, Graves' disease. Effects: Blocks synthesis of thyroid hormones, does not destroy existing thyroid hormone.

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Glucocorticoids (e.g., Dexamethasone)

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Indications: Thyroid storm. Effects: Suppresses TSH, inhibits peripheral conversion of T4 to T3, provides anti-inflammatory effects.

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Sodium ipodate

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Indications: Thyroid storm. Effects: Oral contrast agent that inhibits the conversion of T4 to T3, also decreases thyroid hormone release.

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Levothyroxine

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Indications: Hypothyroidism, TSH suppression. Effects: Replacement of or supplement to endogenous thyroid hormones, increases metabolic rate.

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Liotrix

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Indications: Hypothyroidism. Effects: Combination of synthetic T4 and T3 in a 4:1 ratio, mimics normal thyroid hormone secretion.

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Propranolol

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Indications: Thyrotoxicosis symptoms control, Thyroid storm. Effects: Non-selective beta-blocker, provides symptomatic relief of tachycardia and anxiety caused by hyperthyroidism.

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Esmolol

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Indications: Thyroid storm, Perioperative tachycardia in hyperthyroidism. Effects: Ultra short-acting beta-1 selective blocker, reduces heart rate and myocardial contractility.

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Propylthiouracil (PTU)

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Indications: Hyperthyroidism, Graves' disease, Thyroid storm. Effects: Inhibits thyroid peroxidase, blocking synthesis of T3 and T4; also blocks peripheral conversion of T4 to T3.

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Thyroid desiccated

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Indications: Hypothyroidism. Effects: Natural extract containing T3 and T4, used when synthetic hormones are not feasible.

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Cholestyramine

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Indications: Hyperthyroidism. Effects: Bile acid sequestrant that binds thyroid hormones in the intestine, reducing their enterohepatic circulation.

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