C2: thyroid disease / osteoporosis Flashcards

1
Q

RF for thyroid disease?

A
  • female
  • age >50
  • family history
  • smoking
  • goitrogenic foods e.g. cabbage
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2
Q

SS of hypothyroidism?

A
  • depression, mood swings
  • high cholesterol
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3
Q

SS of hyperthyroidism?

A
  • anxiety, nervousness
  • hand tremors
  • increased appetite
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4
Q

hyperthyroidism condition - thyroid function test

A

low TSH, high T4, high/normal T3

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5
Q

treatment for hypothyroidism?

A

levothyroxine

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6
Q

treatment for hyperthyroidism?

A

carbimazole/PTU, propranolol

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7
Q

levothyroxine: pharm class & indi

A

thyroid hormone
substitution therapy in hypothyroidism

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8
Q

levothyroxine: SE

A

flushing, hd, heat intolerance, weight loss

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9
Q

levothyroxine: contra

A

must not be initiated in patients with acute myocardial infarction, acute …carditis

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10
Q

levothyroxine: CP

A
  • 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
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11
Q

carbimazole: pharm class & indi

A

antithyroid drug, hyperthyroidism

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12
Q

carbimazole: SE

A

mild GI disturbances, minor pruritic rash, taste disturbance

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13
Q

PTU: SE

A

pruritus, rash, taste disturbance

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14
Q

carbimazole/PTU: CP

A
  • 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
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15
Q

propranolol: pharm class & indi

A

beta blocker, adjunct treatment of thyrotoxicosis

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16
Q

propranolol: SE

A

bradycardia, bronchospasm, coldness of extremities, hypotension

17
Q

propranolol: CP

A
  • inform healthcare professionals if SE do not go away
  • dz & lightheadedness
  • feeling weak & tired, heart beats slower
18
Q

which preferred in elderly for hyperthyroidism?

A

carbimazole, not PTU
dosing easier to comply & fewer SE

19
Q

osteoporosis: SS? complications?

A

deterioration of bone tissue -> bone fragility & increased fracture risk
- no SS
- complication: bone fractures in spine or hip

20
Q

RF for osteoporosis?

A
  • age > 65
  • family history
21
Q

treatment of osteoporosis?

A

bisphosphonates: oral - alendronic acid / risedronate
+ Ca / vitD supplements

22
Q

alendronic acid: dose

A

postmenopausal women - 10mg daily or 70mg once weekly

23
Q

alendronic acid: SE

A

GI mucosal irritation, GI disturbance

24
Q

risedronate Na: dose

A

35mg once weekly

25
Q

alendronic acid/ risedronate: CP

A
  • 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
26
Q

osteoporosis: non-pharm management

A

sufficient intake of Ca (1000mg) & vitD

27
Q

summary of drugs

A

levothyroxine
carbimazole/PTU
propranolol

alendronic acid/risedronate + Ca/vitD