Antithyroid Agents

Question 1

What are anti thyroid agents

Answer 1

Thiomides: Propylthiouracil (PTU), methimazole
Iodine Solutions: strong iodine solution, potassium iodide, sodium iodide (131/123)

Question 2

Thiomide actions

Answer 2

Prevent formation of thyroid hormone in thyroid cells

Question 3

Sodium Iodide 131/123 actions

Answer 3

Enters thyroid cells and destroys them by giving off radiation

Question 4

Strong iodine solution and potassium iodide actions

Answer 4

Saturate thyroid cells preventing thyroid hormone formation

Question 5

Indications for thiomides

Answer 5

Hyperthyroidism

Question 6

Indications for Na Iodide (131/123)

Answer 6

Low dose: diagnose/eval thyroid function
High dose: hyperthyroidism/ radiation emergencies

Question 7

Indications for strong iodide/ K Iodide

Answer 7

Hyperthyroidism, radiation emergencies, suppression of thyroid glad, acute thyrotoxicosis

Question 8

Contraindications for all anti thyroid agents

Answer 8

allergy

Question 9

PTU cautions

Answer 9

Liver impairment (extremely hepatotoxic)

Question 10

Adverse effects for all anti thyroid meds:

Answer 10

Hypothyroidism

Question 11

Methimaxole adverse effects

Answer 11

Bone marrow suppression

Question 12

PTU adverse effects

Answer 12

Severe liver toxicity

Question 13

Iodine solutions adverse effects

Answer 13

Iodism (iodine toxicity)

Question 14

DDIs for anti thyroid agents

Answer 14

Oral anticoags
Theophylline
Beta blockers
Digoxin

Question 15

Assessment for antithyroids agents

Answer 15

Hx: allergy, liver impairment
Physical: assess skin, CNS, vitals, EKG
Labs: thyroid function, CBC, liver function, pregnant

Question 16

Nursing Diagnosis/ conclusions

Answer 16

Altered cardiac output, malnutrition risk: less than body requirements, injury/risk and bleeding risk, knowledge deficit

Question 17

Implementation for anti thyroid agents

Answer 17

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

Question 18

Evaluation for anti thyroid agents

Answer 18

Pt response? Adverse effects?
Effective of teaching plan?
Effective comfort/safety measures?
Compliance to regimen?

Question 19

S/s of hyperthyroidisms

Answer 19

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

Question 20

What are causes of hyperthyroidism

Answer 20

Graves’ disease

Question 21

What is the preferred drug for hyperthyroidism in younger adults

Answer 21

Methimazole
Do not use: PTU, radioactive agents

Question 22

What anti thyroid drug is best for pregnancy

Answer 22

PTU less passes through the placenta

Question 23

What happens when older adults take methimaxole and sodium iodide

Answer 23

Sodium iodide effect fertility
Methimazole side effects are worse (bone marrow suppression)

Question 24

What antithyroid med is best for older adults

Answer 24

Sodium iodide

Question 25

What extra precaution should the nurse take with older adults

Answer 25

Monitor for hypothyroidism can develope after one year of antithyroid meds