00 Thyroid Disorders Flashcards
Which hormone is Triiodothyronine?
T3
Which hormone is Thyroxine?
T4
What is the most common cause of Hypothyroidism?
Hashimoto’s Disease (autoimmune thyroiditis, a condition that destroys the thyroid gland)
What are some drugs that can induce hypothyroidism?
Octreotide, Amiodarone, Interferon, Lithium
What are the most common symptoms of Hypothyroidism?
Cold intolerance, Dry skin, Fatigue, Weight gain, Depression, Constipation
What are the hormone levels like in someone with Clinical Hypothyroidism?
High TSH, low T4 & T3
What is the generic name of Levothyroid?
Levothyroxine (T4 only)
What is the generic name of Synthroid?
Levothyroxine (T4 only)
What is the generic name of Levoxyl?
Levothyroxine (T4 only)
What is the generic name of Unithroid?
Levothyroxine (T4 only)
What is the generic name of Tirosint?
Levothyroxine (T4 only)
What is the generic name of Cytomel?
Liothyronine (T3 only)
What is the generic name of Armour Thyroid?
Desiccated Thyroid (T3 and T4)
What is the generic name of Nature Thyroid?
Desiccated Thyroid (T3 and T4)
Which thyroid medication is the DOC for pregnancy?
Levothyroxine
Which thyroid medication needs to be protected from light and moisture?
Levothyroxine
What are the dose equivalencies like between IV and PO levothyroxine?
IV = 50% of PO dose
When would you want to start with a lower dose of Levothyroxine?
Heart disease. Elderly > 50 years
What common medications can Levothyroxine effect?
Can Decrease: Digoxin, Theophylline, Antidiabetic agents. Can Increase: Effect of warfarin
What is the BBW with Levothyroxine?
In euthyroid patients, thyroid supplements are ineffective and potentially toxic for weight reduction. High doses may produce serious or even life-threatening toxic effects, particularly when used with some anorectic drugs
What is monitoring like for Levothyroxine?
Initial therapy or w/ dose changes: TSH Q1-2 months until euthyroid. Maintenance: TSH Q6-12 months or as clinically indicated
When do you not want to use Levothyroxine?
Acute MI, Thyrotoxicosis, Uncorrected adrenal insufficiency
What is the most common cause of Hypothyroidism?
Grave’s Disease (autoimmune disorder leading to over production and secretion of thyroid hormones)
What medications could cause Hyperthyroidism?
Amiodarone. Interferon. Thyroid hormone supplements
What are some symptoms of Hyperthyroidism?
Irritability, Insomnia, Heat intolerance, Sweating, Tachycardia, Tremor, Diarrhea
What are the thyroid hormone levels like in someone with Clinical Hyperthyroidism?
Low TSH. High T4 & T3
Usually subclinical hyperthyroidism isn’t treated, but when might you consider it?
> 65 years w/ heart disease. Pregnant. Symptoms of hyperthyroidism present
What is the generic name of Propyl-Thyracil?
Propylthiouracil (PTU)
What is the generic name of Tapazole?
Methimazole (MMI)
What is different about PTU compared to Methimazole?
Both inhibit synthesis of thyroid hormones, but PTU also blocks CONVERSION of T4 to T3 at higher doses
Which hyperthyroid treatment option is preferred in pregnancy?
PTU
What is the BBW with PTU?
Hepatotoxicity
What is the treatment of choice for Grave’s and Plummer’s Diseases?
Radioactive Iodine (RAI)
When is Radioactive Iodine (RAI) contraindicated?
Pregnancy, Lactation, Thyroid cancer
What are the Iodide therapy options?
Lugol’s Solution (Potassium iodide and iodine solution). SSKI (saturated solution of potassium iodide)
Which beta-blockers can be used in Hyperthyroidism to help block symptoms?
Propranolol, Nadolol, Metoprolol, Atenolol, Esmolol
Which beta-blockers may actually block the conversion of T4 to T3 at higher doses?
Propranolol and Nadolol
What are some precipitating factors of thyroid storm (medical emergency)?
Infection, MI, diabetes, trauma
What are the symptoms caused by Thyroid Storm?
Fever > 103. Tachycardia > 140. Tachypnea. Sweating. Agitation, psychosis, coma
What is used to treat thyroid storm?
All used together: PTU (or Methimazole), Propranolol (or esmolol), SSKI (only start 1 hour after antithyroid medications), Hydrocortisone (or dexamethasone)
What is hyperthyroidism treatment like in pregnancy?
PTU is preferred during 1st trimester. Switch to MMI during 2nd and 3rd trimester. If unable to tolerate these, consider surgery (2nd trimester is ideal for thyroidectomy)
Which thyroid medication should be avoided in someone allergic to pigs?
Armour Thyroid