Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adv Pharm > Chapter 49: Thyroid Disorders > Flashcards

Chapter 49: Thyroid Disorders Flashcards

1
Q

TH

A

Profound effect on:
Metabolism
Stimulates energy use

Cardiac function
Cardiac stimulation

Growth
Promotes maturation in infancy and childhood

Development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thyroid

A

Produces two active hormones whose synthesis is stimulated by low plasma levels of iodine
Triiodothyronine (T3)
Synthetic T3: Liothyronine
Thyroxine (T4, tetraiodothyronine)
Synthetic T4: Levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thyroid function test

A

Serum thyroid-stimulating hormone (TSH)
Screening and diagnosis of hypothyroidism
Elevated TSH is an indicator of hypothyroidism (inverse relationship)

Serum T4 test
Can measure total T4 or free T4

Serum T3 test
Can measure total T3 or free T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypothyroidism

A

Severe deficiency of thyroid hormone

Myxedema (adults)
Replacement therapy with thyroid hormones; in almost all cases, treatment must continue lifelong

Hypothyroidism during pregnancy
To help ensure healthy fetal development, maternal hypothyroidism must be diagnosed and treated very early

Cretinism (infancy)
Replacement therapy with thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hypothyroidism in adults -clinical presentation

A

Pale, puffy face
Cold, dry skin
Brittle hair or loss of hair
Lowered heart rate and temperature
Lethargy and fatigue
Intolerance to cold
Impaired mentality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypothyroidism in adults: causes

A

Usually due to malfunction of the thyroid
Hashimoto disease: Chronic autoimmune thyroiditis
Insufficient iodine in the diet
Surgical removal of thyroid and destruction of thyroid with radioactive iodine
Insufficient secretion of TSH and thyrotropin-releasing hormone (TRH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypothyroidism in adults -tx

A

Therapeutic strategy

Lifelong replacement therapy
Levothyroxine (T4)
Liothyronine (T3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypothyroidism: Life Span Issues

A

During pregnancy
In first trimester can result in permanent neuropsychologic deficits in the child

In infants
May be permanent or transient
Can cause mental retardation and derangement of growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Two Forms of Hyperthyroidism

A

Graves disease
Most common form
Affects women age 20 to 40 years
Causes exophthalmos

Toxic nodular goiter (Plummer disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hyperthyroidism causes

A

Thyroid-stimulating immunoglobulins (TSI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperthyroidism tx

A

Surgical removal of thyroid tissue
Destruction of thyroid tissue
Suppression of thyroid hormone synthesis
Beta blockers (e.g., propranolol) -Treat overworking heart and tremor
Nonradioactive iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thyrotoxic Crisis (Thyroid Storm) cause

A

Patients with thyrotoxicosis who undergo significant stress (e.g., surgery, illness)
Not triggered by a rise in thyroid hormones
Cannot be identified by laboratory testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thyrotoxic Crisis (Thyroid Storm) s/sx

A

Hyperthermia (105 F or higher), severe tachycardia, restlessness, agitation, tremor, unconsciousness, coma, hypotension, heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thyrotoxic crisis tx

A

Methimazole
Beta blocker
Sedation, cooling, glucocorticoids, IV fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Levothyroxine [Synthroid]

A

TH prep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Synthroid admin

A

Should be taken in the morning at least 30 to 60 minutes before breakfast

17
Q

Synthroid ADR

A

Tachycardia
Angina
Tremors
Can intensify effects of warfarin

18
Q

Synthroid drug interactions

A

Drugs that reduce levothyroxine absorption
Drugs that accelerate levothyroxine metabolism
Warfarin
Catecholamines

19
Q

Other thyroid prep

A

Liotrix [Thyrolar]

Thyroid (Armour Thyroid, others)
From desiccated animal thyroid glands
Rarely used

20
Q

Methimazole

A

First-line drug for hyperthyroidism
Prototype of the thioamides
Does not cause the liver damage associated with propylthiouracil (PTU)
Does not destroy existing stores of thyroid hormone
May take 3 to 12 weeks for euthyroid state
More dangerous than PTU during lactation and during the first trimester of pregnancy

21
Q

Methimazole ADR

A

Agranulocytosis
Make sure pt knows s/sx of infection and seek medical attention

22
Q

Methimazole 4 uses in hyperthyroidism

A

Sole form of therapy for Graves disease
Adjunct to radiation therapy until the effects of radiation become manifest
Suppresses thyroid hormone synthesis in preparation for thyroid gland surgery (subtotal thyroidectomy)
Thyrotoxic crisis

23
Q

Propylthiouracil (PTU)

A

Inhibits thyroid hormone synthesis
Second-line drug for Graves disease
Short half-life (about 90 min)
Full benefits may take 6 to 12 months

24
Q

PTU therapeutic uses

A

Graves disease
Adjunct to radiation therapy
Preparation for thyroid gland surgery
Thyrotoxic crisis

25
Q

PTU ADR

A

Agranulocytosis (most serious)
Hypothyroidism
Pregnancy and lactation
Can cause severe liver damage

26
Q

PTU Versus Methimazole

A

PTU can cause severe liver injury, whereas methimazole does not

PTU has a shorter half-life than methimazole (90 min compared to 6 to 13 hr), so it requires two or three daily doses rather than one

PTU crosses the placenta less readily than does methimazole, and concentrations in breast milk are lower

PTU blocks conversion of T4 to T3 in the periphery, whereas methimazole does not

27
Q

Radioactive Iodine-131 (131I)

A

Radioactive isotope of stable iodine
Emits gamma and beta rays
Half-life: 8 days
2 to 3 months for full effect

28
Q

Radioactive iodine 131 use in Graves’ disease

A

destorys thyroid tissue
Pt becomes hypothyroid

29
Q

Radioactive iodine 131 advantages and disadvantages

A

Adv: low cost, pt do not have to get thyroid sx, death is rare, no other tissue besides thyroid is harmed,

Dis: tx has delayed effect, hypothyroidism

30
Q

Nonradioactive Iodine: Strong iodine solution (Lugol solution)

A

Used to suppress thyroid function in preparation for thyroidectomy. PO

31
Q

Lugol solution ADR

A

Brassy taste
Burning sensation in the mouth and throat
Soreness of the teeth and gums
Frontal headache
Coryza
Salivation
Various skin eruptions

32
Q

Beta blockers

A

Propranolol: Can suppress tachycardia and other symptoms of Graves’ disease

Benefits derive from beta-adrenergic blockade, not from reducing levels of T3 or T4

Beneficial in thyrotoxic crisis

Adv Pharm (76 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions