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HLSC 220 - Pharmacotherapeutics for Healthcare Professionals > Chapter 61 - Drugs for Thyroid Disorders > Flashcards

Chapter 61 - Drugs for Thyroid Disorders Flashcards

1
Q

What do thyroid hormones effect?

A

-metabolism
-cardiac function
-growth
-development

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2
Q

What is the role of the parathyroid gland?

A

maintaining calcium fluid in the ECF

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3
Q

What induces thyroid hormone synthesis?

A

low plasma levels of iodine

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4
Q

What drug mimics T3 (triiodothyronine)?

A

liothyronine

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5
Q

What drug mimics thyroxine (T4)?

A

levothyroxine

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6
Q

The serum TSH test is used to screen and diagnose for ____________?

A

hypothyroidism

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7
Q

Elevates TSH indicates ____________

A

hypothyroidism

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8
Q

What is the preferred measure to monitor thyroid replacement drugs?

A

serum TSH

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9
Q

What does the serum T4 test measure?

A

total T4 or free T4

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10
Q

What is the preferred measure for hyperthyroidism?

A

serum T3 test (total and free)

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11
Q

Myxedema is a form of ______thyroidism in _______

A

hypo; adults

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12
Q

What is the treatment for myxedema?

A

lifelong (usually) replacement hormone therapy

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13
Q

What condition is responsible for hypothyroidism during pregnancy?

A

myxedema

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14
Q

Cretinism is a type of _______thyroidism in _______

A

hypo; infancy

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15
Q

How does hypothyroidism present in adults?

A

-pale, puffy face
-cold, dry skin
-hair loss
-lowered HR
-low temp.
-fatigue
-intolerance to cold
-impaired mentality

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16
Q

What can cause hypothyroidism in adults?

A

-thyroid malfunction
-Hashimoto’s disease
-insufficient iodine in diet
-thyroid removal
-insufficient TSH and TRH

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17
Q

What drugs are used for hypothyroidism?

A

-levothyroxine (most common) T4
-liothyronine T3

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18
Q

How can hypothyroidism affect pregnancy?

A

cause neuropsychologic deficits in the child

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19
Q

How can cretinism affect infants?

A

-intellectual disability
-growth deficit

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20
Q

Graves’ disease is a form of _______thyroidism

A

hyper

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21
Q

What is the most common form of hyperthyroidism?

A

Graves’ disease

22
Q

Toxic nodular goiter aka Plummer’s disease is a form of ______thyroidism

A

hyper

23
Q

What is the cause of Grave’s disease?

A

thyroid-stimulating immunoglobulins (autoimmune antibodies)

24
Q

What is the treatment of Grave’s disease?

A

-surgical removal
-TSH suppression
-beta blockers
-nonradioactive iodine

25
Q

What causes thyrotoxic crisis (thyroid storm)?

A

-stress
-not rise in TH’s
-not identified in lab testing

26
Q

What are the signs of thyroid storm?

A

-hyperthermia
-severe tachycardia
-restlessness
-agitation
-tremor
-coma
-hypotension
-HF

27
Q

What is the treatment for thyroid storm?

A

-methimazole
-beta blocker
-sedation
-cooling
-glucocorticoids
-IV fluids

28
Q

What is levothyroxine?

A

a synthetic form of thyroxine (T4) that is converted to T3 in the body

29
Q

What is levothyroxine used for?

A

hypothyroidism

30
Q

When is levothyroxine taken?

A

in the morning - 30-60 mins before breakfast

31
Q

What are the adverse effects of levothyroxine?

A

-tachycardia
-angina
-tremors

32
Q

When do peak effects of levothyroxine occur?

A

3-4 weeks

33
Q

How long do the effects of levothyroxine last?

A

1-3 weeks but dosed daily

34
Q

How does levothyroxine travel in the blood?

A

99% protein bound

35
Q

How long does levothyroxine remain in the blood after discontinuation?

A

3 weeks

36
Q

What is methimazole used for?

A

hyperthyroidism

37
Q

How does methimazole act?

A

blocks synthesis of thyroid hormones

38
Q

Does methimazole cross the placenta?

A

yes

39
Q

Is methimazole used during pregnancy?

A

no

40
Q

How long does it take for methimazole to take effect?

A

3-12 weeks

41
Q

What are the adverse effects of methimazole?

A

-agranulocytosis
-hypothyroidism
-skin rash
-muscle aches
-abnormal taste/smell

42
Q

What is the blood work needed for methimazole?

A

-hepatic
-renal
-CBC
-TSH

43
Q

What are the possible complications of propylthiouracil (for hyperthyroidism)?

A

-risk of liver failure
-agranulocytosis

44
Q

Nursing implications of anti-thyroid meds:

A

-better tolerated with food
-take at same time each day
-don’t stop abruptly
-avoid high iodine foods

45
Q

What is radioactive iodine-131?

A

a radioactive isotope of stable iodine

46
Q

What does 131I emit?

A

gamma and beta rays

47
Q

How long does it take for 131I to take full effect?

A

2-3 months

48
Q

When is 131I used?

A

grave’s disease to destroy thyroid tissue

49
Q

When is 131I used?

A

with no response to meds

50
Q

When is 131I not used?

A

pregnancy and lactation

HLSC 220 - Pharmacotherapeutics for Healthcare Professionals (18 decks)

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