Antithyroid Agents Flashcards
What are anti thyroid agents
Thiomides: Propylthiouracil (PTU), methimazole
Iodine Solutions: strong iodine solution, potassium iodide, sodium iodide (131/123)
Thiomide actions
Prevent formation of thyroid hormone in thyroid cells
Sodium Iodide 131/123 actions
Enters thyroid cells and destroys them by giving off radiation
Strong iodine solution and potassium iodide actions
Saturate thyroid cells preventing thyroid hormone formation
Indications for thiomides
Hyperthyroidism
Indications for Na Iodide (131/123)
Low dose: diagnose/eval thyroid function
High dose: hyperthyroidism/ radiation emergencies
Indications for strong iodide/ K Iodide
Hyperthyroidism, radiation emergencies, suppression of thyroid glad, acute thyrotoxicosis
Contraindications for all anti thyroid agents
allergy
PTU cautions
Liver impairment (extremely hepatotoxic)
Adverse effects for all anti thyroid meds:
Hypothyroidism
Methimaxole adverse effects
Bone marrow suppression
PTU adverse effects
Severe liver toxicity
Iodine solutions adverse effects
Iodism (iodine toxicity)
DDIs for anti thyroid agents
Oral anticoags
Theophylline
Beta blockers
Digoxin
Assessment for antithyroids agents
Hx: allergy, liver impairment
Physical: assess skin, CNS, vitals, EKG
Labs: thyroid function, CBC, liver function, pregnant
Nursing Diagnosis/ conclusions
Altered cardiac output, malnutrition risk: less than body requirements, injury/risk and bleeding risk, knowledge deficit
Implementation for anti thyroid agents
Methimazole/ PTU 3x a day round the clock
Iodine solution through a straw (can stain teeth)
Periodic blood tests: (TSH/ liver/ T4/T3)
Assess pt receiving iodine solution for s/s of iodism
PT teaching
Evaluation for anti thyroid agents
Pt response? Adverse effects?
Effective of teaching plan?
Effective comfort/safety measures?
Compliance to regimen?
S/s of hyperthyroidisms
Intolerance to heat
Fine hair
Bulging eyes
Facial flushing
Enlarged thyroid
Increase sys BP
breast enlargement
Weight loss
Muscle wasting
Diarrhea
Menstrual changes
Tremors
Finger clubbing
Local edema
What are causes of hyperthyroidism
Graves’ disease
What is the preferred drug for hyperthyroidism in younger adults
Methimazole
Do not use: PTU, radioactive agents
What anti thyroid drug is best for pregnancy
PTU less passes through the placenta
What happens when older adults take methimaxole and sodium iodide
Sodium iodide effect fertility
Methimazole side effects are worse (bone marrow suppression)
What antithyroid med is best for older adults
Sodium iodide
