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Pharm U5 > 3) Thyroid - U5 > Flashcards

3) Thyroid - U5 Flashcards

1
Q

What is the class for Levothyroxine sodium (Synthroid)

A

Synthetic thyroid hormone (T4)

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2
Q

What is the mechanism for Levothyroxine sodium (Synthroid)

A

Converted to T3 in liver; T3 binds toTR complex to influence gene expression

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3
Q

What are the therapeutics for Levothyroxine sodium (Synthroid)

A

Drug of choice for hypothyroidism (longer half-life than T3)

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4
Q

What are the important side effects for Levothyroxine sodium (Synthroid)

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

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5
Q

What are the miscellaneous for Levothyroxine sodium (Synthroid)

A

Start low, go slow in patients with angina pectoris, CAD, and elderly; requires periodic monitoring and adjustment (especially during pregnancy); not effective in Chronic Fatigue Syndrome

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6
Q

What is the class for Liothyronine sodium (Cytomel)

A

Synthetic thyroid hormone (T3)

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7
Q

What is the mechanism for Liothyronine sodium (Cytomel)

A

T3 binds to TR complex in nucleus to influence gene expression

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8
Q

What are the therapeutics for Liothyronine sodium (Cytomel)

A

Acute management of hypothyroidism (rapid effect); myxedema coma (IV formulation)

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9
Q

What are the important side effects for Liothyronine sodium (Cytomel)

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

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10
Q

What are the miscellaneous for Liothyronine sodium (Cytomel)

A

4X as potent as T4, but not desirable for chronic replacement (less stable, more costly, transient high levels)

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11
Q

What is the class for Liotrix (Thyrolar)

A

Synthetic thyroid hormone (T4 & T3)

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12
Q

What is the mechanism for Liotrix (Thyrolar)

A

Converted to T3 in liver; T3 binds toTR complex to influence gene expression

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13
Q

What are the therapeutics for Liotrix (Thyrolar)

A

Thyroid hormone replacement therapy (4:1 mix of T4:T3; not used much)

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14
Q

What are the important side effects for Liotrix (Thyrolar)

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

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15
Q

What is the class for Propylthiouracil

A

Thioamide (thyroid peroxidase inhibitors)

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16
Q

What is the mechanism for Propylthiouracil

A

Inhibit organification of iodide and coupling of iodotyrosine; also reduces peripheral deiodination of T4 to T3

17
Q

What are the therapeutics for Propylthiouracil

A

Hyperthyroidism; thyrotoxicosis (high dose); drug of choice for hyperthyroidism during pregnancy

18
Q

What are the important side effects for Propylthiouracil

A

Rare side effects: hepatitis, agranulocytosis (higher than methimazole), lupus-like syndrome

19
Q

What are the miscellaneous for Propylthiouracil

A

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus

20
Q

What is the class for Methimazole (Tapazole)

A

Thioamide (thyroid peroxidase inhibitors)

21
Q

What is the mechanism for Methimazole (Tapazole)

A

Inhibit organification of iodide and coupling of iodotyrosine; active metabolite of carbimazole; less effect on T4 to T3 conversion

22
Q

What are the therapeutics for Methimazole (Tapazole)

A

Hyperthyroidism; thyrotoxicosis (high dose)

23
Q

What are the important side effects for Methimazole (Tapazole)

A

Rare side effects: hepatitis, agranulocytosis (less than propylthiouracil), lupus-like syndrome

24
Q

What are the miscellaneous for Methimazole (Tapazole)

A

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus

25
Q

What is the class for Carbimazole (Neomercazole)

A

Thioamide (thyroid peroxidase inhibitors)

26
Q

What is the mechanism for Carbimazole (Neomercazole)

A

Prodrug converted to methimazole; Inhibits organification of iodide and coupling of iodotyrosine; less effect on T4 to T3 conversion

27
Q

What are the therapeutics for Carbimazole (Neomercazole)

A

Hyperthyroidism; thyrotoxicosis (high dose)

28
Q

What are the important side effects for Carbimazole (Neomercazole)

A

Rare side effects: hepatitis, agranulocytosis, lupus-like syndrome

29
Q

What are the miscellaneous for Carbimazole (Neomercazole)

A

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus; not available in US

30
Q

What is the class for Radioactive Iodine

A

Radioactive isotope

31
Q

What is the mechanism for Radioactive Iodine

A

Radioactive agent that emits beta particles and gamma rays that destroy thyroid cells

32
Q

What are the therapeutics for Radioactive Iodine

A

Treatment of choice for hyperthyroidism after antithyroid drug therapy; ablation after cancer

33
Q

What are the important side effects for Radioactive Iodine

A

Transient or permanent hypothyroidism; increases cancer risk

34
Q

What are the miscellaneous for Radioactive Iodine

A

Contraindicated in pregnant/breast feeding, patients under 10; monitor serum thyroid hormones post-treatment every 2-3 months for first year

35
Q

What is the class for ?-blockers

A

?-blockers

36
Q

What is the mechanism for ?-blockers

A

Reduce sympathetic tone

37
Q

What are the therapeutics for ?-blockers

A

Symptomatic treatment of hyperthyroidism (no effect on T3 synthesis)

38
Q

What are the miscellaneous for ?-blockers

A

Do not use on patient’s at risk of heart failure! Discontinue use when patient returns to euthyuroid.

Pharm U5 (5 decks)

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