The thyroid are classified as either primary

The thyroid gland is anteriorly located in
the neck with the main secretions being T3 and T4 hormones which act as metabolic
regulators in the body. The gland’s functions are regulated by the pituitary
gland found within the brain and it is via a negative and positive feedback
mechanism.  The hormone that takes part
in this regulation is thyroid stimulating hormone (Brent, 2012).  This makes it an important organ in the body
whose dysfunction can lead to serious medical issues and, therefore, proper
management is paramount.

Background

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According to Ross et al., (2016), diseases
that affect the thyroid are classified as either primary (the pathology is
intrinsic to the gland) or secondary (pathology is extrinsic to the gland;
commonly in the pituitary gland). 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
thyroid hormones (Hypothyroidism).  Both
these disease states present clinically with different symptoms such as unintentional
weight loss, excess sweating, intolerance to heat and problems with the eyes
among others for hyperthyroidism, while hypothyroidism symptoms include unintended
gain of weight, cold intolerance 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. Drugs for treating and managing of Hyperthyroidism
include anti-thyroid drugs such as Carbimazole, methimazole, 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 hyper-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 which is a T4
analogue is used in hypothyroidism to normalize serum levels of T4..

Other causes of thyroid dysfunction are
immune related 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), levothyroxine and
corticosteroid prednisolone to reduce thyroid inflammation.

Effects
of age on thyroid Medications

The pharmacodynamics and pharmacokinetics
of drugs are affected by patients’ ages and therefore, in the very young and
very old population, there are differences in the drug elimination rates, drug metabolism,
and compositions of body might affect the bioavailability, duration of action,
the route and methods of administration and even dosing of drugs which consequently
affect impact drug actions in those groups. The drugs that are majorly
eliminated via the kidneys end up remaining in the body for longer if the renal
system is impaired in any way such as in the elderly population. 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 might be administered differently, which will directly or
indirectly 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 used
for management of autoimmune thyroid disease can have many side effects on
almost all systems in the body including 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 easily resolves upon drug
withdrawal.  Propylthiouracil has a small
risk for hepatotoxicity and as such it is important to keep conducting test to
maintain appropriate liver health and functions.. 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 thyroid 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 adequate remission it to be achieved.

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