Nishikawa Mitsushige, Toyoda Nagaoki, Nomura Emiko
Internal Medicine II, Kansai Medical University.
Nihon Rinsho. 2012 Nov;70(11):1958-64.
Various drugs may cause thyroid dysfunction. The drugs which may cause thyrotoxicosis include interferon, molecular-targeted agents, amiodarone, thyroid hormone itself and so on. Those which cause hypothyroidism include anti-thyroid drugs, lithium and iodine etc. which inhibit thyroid hormone synthesis and secretion, and dopamine etc. which block TSH secretion. Those drugs which alter the thyroid hormone metabolism or the binding to TBG or those inhibit thyroid hormone absorption may cause hypothyroidism or deteriorate it in patients with hypothyroidism treated with thyroid hormone or those with diminished reserved capacity. When thyroid dysfunction occurred, it is better to discontinue the causative drug, but in many cases, the patients are forced to be treated with the drug being continued.
多种药物可能导致甲状腺功能障碍。可引起甲状腺毒症的药物包括干扰素、分子靶向药物、胺碘酮、甲状腺激素本身等。导致甲状腺功能减退的药物包括抑制甲状腺激素合成和分泌的抗甲状腺药物、锂和碘等,以及阻断促甲状腺激素分泌的多巴胺等。那些改变甲状腺激素代谢或与甲状腺激素结合球蛋白的结合,或抑制甲状腺激素吸收的药物,可能导致甲状腺功能减退,或使接受甲状腺激素治疗的甲状腺功能减退患者或储备能力降低的患者病情恶化。当发生甲状腺功能障碍时,最好停用致病药物,但在许多情况下,患者不得不继续使用该药物进行治疗。