C2: thyroid disease / osteoporosis Flashcards
RF for thyroid disease?
- female
- age >50
- family history
- smoking
- goitrogenic foods e.g. cabbage
…
SS of hypothyroidism?
- depression, mood swings
- high cholesterol
SS of hyperthyroidism?
- anxiety, nervousness
- hand tremors
- increased appetite
hyperthyroidism condition - thyroid function test
low TSH, high T4, high/normal T3
treatment for hypothyroidism?
levothyroxine
treatment for hyperthyroidism?
carbimazole/PTU, propranolol
levothyroxine: pharm class & indi
thyroid hormone
substitution therapy in hypothyroidism
levothyroxine: SE
flushing, hd, heat intolerance, weight loss
levothyroxine: contra
must not be initiated in patients with acute myocardial infarction, acute …carditis
levothyroxine: CP
- morning (at least 30-60mins b4 food)
- important to keep to same brand
- avoid milk, indigestion remedies e.g. iron supplements 2h b4 med
- during adjustment of doses, experience palpitations or weight loss -> inform doc
carbimazole: pharm class & indi
antithyroid drug, hyperthyroidism
carbimazole: SE
mild GI disturbances, minor pruritic rash, taste disturbance
PTU: SE
pruritus, rash, taste disturbance
carbimazole/PTU: CP
- full benefits take up to 8 weeks
- rare but serious SE requires med discontinuation & immediate medical attention
- ^ if develop ST, mouth ulcers & fever
- ^ tea-coloured (dark brown) urine, yellowing of eyes/skin, AP
- ^ skin rashes & itch
propranolol: pharm class & indi
beta blocker, adjunct treatment of thyrotoxicosis
propranolol: SE
bradycardia, bronchospasm, coldness of extremities, hypotension
propranolol: CP
- inform healthcare professionals if SE do not go away
- dz & lightheadedness
- feeling weak & tired, heart beats slower
which preferred in elderly for hyperthyroidism?
carbimazole, not PTU
dosing easier to comply & fewer SE
osteoporosis: SS? complications?
deterioration of bone tissue -> bone fragility & increased fracture risk
- no SS
- complication: bone fractures in spine or hip
RF for osteoporosis?
- age > 65
- family history
…
treatment of osteoporosis?
bisphosphonates: oral - alendronic acid / risedronate
+ Ca / vitD supplements
alendronic acid: dose
postmenopausal women - 10mg daily or 70mg once weekly
alendronic acid: SE
GI mucosal irritation, GI disturbance
risedronate Na: dose
35mg once weekly
alendronic acid/ risedronate: CP
- same day of the week
- plenty of water
- empty stomach/ at least 3mins b4 bf
- do not take milk/antacids/supplements…
- stand or sit upright for at least 30mins after administration
- develop symptoms of esophageal irritation -> inform doc
osteoporosis: non-pharm management
sufficient intake of Ca (1000mg) & vitD
summary of drugs
levothyroxine
carbimazole/PTU
propranolol
alendronic acid/risedronate + Ca/vitD
