Chapter 37 - Thyroid and Parathyroid Agents

Question 1

Levothyroxine (I)

Answer 1

Thyroid Hormone
Replacement therapy in hypothyroidism
Pituitary thyroid stimulating hormone suppression in the treatment of euthyroid goiters and in the management of thyroid cancer
Thyrotoxicosis in conjunction with other therapy
myxedma coma

Question 2

Levothyroxine (A)

Answer 2

Increases the metabolic rate of body tissues
increasing oxygen consumption, respiration, and heart rate
the rate of fat, protein, and carb metabolism, and growth and maturation

Question 3

Levothyroxine (AE)

Answer 3

Tremors
Loss of hair in first few months with children
difficulty swallowing
TAKE DRUG WITH FULL GLASS OF WATER

Question 4

Levothyroxine (D-D & CI)

Answer 4

CI:
Acute MI
Thyrotoxicosis (unless used in conjunction with antithyroid drugs)
Addisons Disease

D-D:
Anticoagulants (^effect)
Digitalis Glycosides (v effect)
Theophylline

Question 5

Methimazole (I &A)

Answer 5

Antithyroid Thiamide
Treatment of hyperthyroidism
Inhibits the synthesis of thyroid hormones

Question 6

Methimazole (AE)

Answer 6

Bonemarrow suppression
Parethesias
skin pigmentation
epigastric distress (but less than others)

Question 7

Methimazole (D-D & CI)

Answer 7

CI:
Pregnancy (baby develops cretinism
Feeding (baby can get a goiter)

D-D:
none

Question 8

Strong Iodine Products (I&A)

Answer 8

Antithyroid Iodine Solutions
Indications:
Adjunct therapy for hyperthyroidism; thyroid blocking in a radiation emergency
Actions:
Inhibits the synthesis of thyroid hormones and inhibit the release of these hormones into the circulation.

Question 9

Strong Iodine Products (AE)

Answer 9

hypothyroidism (PT will need replacement therapy)
goiter
iodism
swelling of salivary glands

Question 10

Strong Iodine Products (CI&D-D)

Answer 10

CI:
Pulmonary edema or pulmonary TB

D-D:
Drugs that have a small margin of safety:
anticoags
theophylline
digoxin
metoprolol
propanolol

Question 11

Calcitriol (I)

Answer 11

Antihypocalcemic Agent

Management of hypocalcemia in patients on chronic renal dialysis
Management of hypocalcemia ass. with hypoparathyroidism

Question 12

Calcitriol (A)

Answer 12

A vitamin D compound that regulates the absorption of calcium and phosphate from the small intestine, mineral resorption of bone, and reabsorption of phosphate from the renal tubules, increasing the serum calcium levels.

Question 13

Calcitriol (AE)

Answer 13

Weakness, dry mouth, bone pain, metallic taste

Question 14

Calcitriol (CI & D-D)

Answer 14

Hypercalcemia or vit. D toxicity
History of renal stones

d-d:
hypermagnesemia if taken with magnesium containing antacids

Reduced absoprtion if taken with mineral oil because they’re fat soluble vitamins.

Question 15

Alendronate (I&A)

Answer 15

Antihypercalcemic Biphosphate
Treatment and prevention of osteoporosis in postmenopausal women and in men
Glucocorticoid induced osteoporosis
Paget’s disease in certain patients

Slows normal and abnormal bone resorption without inhibiting bone formation and mineralization.

Question 16

Alendronate (AE)

Answer 16

Long term use (+5 years) ass. with increased risk of femoral shaft fractures
Esophageal erosion
Bone pain

Question 17

Alendronate (CI&D-D)

Answer 17

CI:
Needs to be taken in the morning 30 minutes before any food or beverage.Must remain upright for 30 minutes.
Hypocalcemia
Causes Fetal abnormalities

D-D:
Antacids/calcium products/iron/multivits (v effects)
GI distress if taken with aspirin

Question 18

Calcitonin Salmon (I&A)

Answer 18

Antihypercalcemic Calcitonin
I: Paget’s Disease, postmenopausal osteoporosis, emergency treatment of hypercalcemia
A: Inhibits bone resorption; lowers elevated serum calcium in children and patients with Paget’s disease; increases the excretion of filtered phosphate, calcium, and sodium by the kidney

Question 19

Calcitonin Salmon (AE)

Answer 19

Flushing of face and hands, urinary frequency

Question 20

Calcitonin Salmon (CI&DD)

Answer 20

CI: Known allergy to salmon or fish products
Pernicious anemia

DD: None