Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHARMACOLOGY (2nd year) > DR. LEAL - THYROID & ANTITHYROID DRIGS > Flashcards

DR. LEAL - THYROID & ANTITHYROID DRIGS Flashcards

1
Q

Function: normalize growth and development, body
temperature, and energy levels.

A

THYROID HORMONES
○ Triiodothyronine (T3)
○ Tetraiodothyronine (T4, Thyroxine)

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

second type of thyroid hormone, is
important in the regulation of calcium metabolism.

A

CALCITONIN

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

Recommended Daily Adult Iodide (I−) Intake:

A

○ 150 mcg
○ 200 mcg during pregnancy and lactation
○ 250 mcg for children

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

absorbed best in the duodenum and ileum.

A

THYROXINE

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

THYROXINE ABSORPTION MODIFIED BY

A

food, drugs, gastric
acidity, and intestinal flora.

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

_ & _
IMPAIRED IN SEVERE MYXEDEMA WITH ILEUS

A

T3 AND T4 ABSORPTION

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

METABOLIC CLEARANCES OF T3 & T4 ARE INCREASED

A

HYPERTHYROIDISM

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

Drugs that induce hepatic microsomal enzymes increase the metabolism of both T4 and T3

A

Rifampin
phenobarbital
Carbamazepine
Phenytoin
Tyrosine kinase inhibitors
HIV protease inhibitors.

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

responsible for optimal growth, development, function, and maintenance of all body tissues.

A

T3 AND T4

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

EXCESS T3 AND T4 (THYROID HORMONES)

A

HYPERTHYROIDISM

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

INADEQUATE T3AND T4

A

HYPOTHYROIDISM

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

T OR F
Thyroid hormones are not effective and can be detrimental in the management of obesity, abnormal vaginal bleeding, or depression if thyroid hormone levels are normal.

A

TRUE

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

SYNTHETIC THYROID HORMONES

A

Levothyroxine
Liothyronine
Liotrix

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

CHOICE FOR THYROID REPLACEMENT & SUPPRESSION THERAPY

A

LEVOTHYROXINE (T4)

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

Long half-life (7 days), which permits once-daily to weekly administration

A

LEVOTHYROXINE (T4)

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

● 3-4x more potent than Levothyroxine
● Best reserved for short-term TSH suppression.
● Not recommended for routine replacement therapy

A

LIOTHYRONINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AVOIDED IN PTS WITH CARDIAC DSE
GREATER RISK OF CARDIOTOXICITY

A

LIOTHYRONINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

○ Agents that interfere with the production
of thyroid hormones
○ Agents that modify the tissue response to
thyroid hormones
○ Glandular destruction with radiation or
surgery

A

ANTITHYROID AGENTS

Reduction of thyroid activity and hormone effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Agents that suppress secretion of T3 and T4 to subnormal levels and thereby increase TSH, which in turn produces glandular enlargement (goiter).

A

GOITROGENS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Antithyroid compounds:

A

○ Thioamides
○ Iodides
○ Radioactive iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TXFOR THYROTOXICOSIS

A

THIOAMIDES
Methimazole, Carbimazole and Propylthiouracil
(PTU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PREVENT PROTEIN SYNTHESIS

A

THIOAMIDES
Methimazole, Carbimazole and Propylthiouracil
(PTU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ADVERSE EFFECT OF THIOAMIDES
Methimazole, Carbimazole and Propylthiouracil
(PTU)

A

MACULOPAPULAR RASH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MOST DANGEROUS COMPLICATION
THIOAMIDES
Methimazole, Carbimazole and Propylthiouracil
(PTU)

A

AGRANULOCYTOSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CROSS THE PLACENTAL BARRIER

Secreted in low concentrations in breast milk but are
considered safe for the nursing infant.

A

THIOAMIDES
(MCP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

● 10x more potent than Propylthiouracil.
● Drug of choice in adults and children.
● Readily accumulated by the thyroid gland.

A

METHIMAZOLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

● Single daily dose is effective in the management of
mild to severe hyperthyroidism.
● Associated with congenital malformations
● Cholestatic jaundice is more common.

A

METHIMAZOLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

USED FOR
1ST TRIMESTER OF PREGNANCY
THYROID STORM
ADVERSE RXNS TO METHIMAZOLE

A

PROPYLTHIOURACIL (PTU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

more strongly protein-bound and crosses the
placenta less readily.

A

PROPYLTHIOURACIL (PTU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Black box warning:
severe hepatitis,
resulting in death.

A

PROPYLTHIOURACIL (PTU)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Perchlorate (ClO4)
Pertechnetate (TcO4−)
Thiocyanate (SCN-)

A

ANION INHIBITORS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Inhibits the first step of iodine synthesis; block uptake of iodide by the gland through competitive inhibition of the iodide transport mechanism.

A

ANION INHIBITORS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Block thyroidal reuptake of I− in patients with iodine-induced hyperthyroidism

A

POTASSIUM PERCHLORATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ASSOCIATED WITH APLASTIC ANEMIA

A

POTASSIUM PERCHLORATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

● Major antithyroid agents prior to the introduction of the Thioamides in the 1940s.
● Rarely used as sole therapy today.

A

IODIDES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In susceptible individuals, ____ can induce hyperthyroidism (Jod-Basedow Phenomenon) or
precipitate hypothyroidism.

A

IODIDES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Disadvantages of iodide therapy

A

INITIATED AFTER ONSET OF THIOAMIDE THERAPY
AVOIDED IF TX WITH RADIOACTIVE IODINE SEEMS LIKELY
NOT SHOULD BE USED ALONE
CHRONIC USE IN PREGNANCY SHOULD BE AVOIDED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

uncommon and in most cases reversible upon discontinuance.

A

IODISM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

● The only isotope used for treatment of thyrotoxicosis.
● Administered orally in solution as sodium 1311.

A

RADIOACTIVEIODINE131

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Advantages: easy administration, effectiveness, low
expense, and absence of pain.

A

RADIOACTIVEIODINE131

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

should not be administered to pregnant women or nursing mothers, since it crosses the placenta to destroy the fetal thyroid gland and it is excreted in breast milk.

A

RADIOACTIVE IODINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

● Beta blockers without intrinsic sympathomimetic activity are effective therapeutic adjuncts in the management of thyrotoxicosis since many of these symptoms mimic those associated with sympathetic stimulation.
● Beta blockers cause clinical improvement of hyperthyroid symptoms but do not typically alter thyroid hormone levels.

A

ADRENOCEPTOR-BLOCKINGAGENTS
PROPANOLOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

● Most widely studied and used in the therapy of
thyrotoxicosis.
● by inhibiting the peripheral conversion of T4 to T3.

A

PROPRANOLOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

DECREASE T3 AND T4
INCREASE TSH

A

HYPOTHYROIDISM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

DEVELOP DWARFISM AND IRREVERSIBLE MENTAL RETARDATION
CAN OCCUR WITH OR WITHOUT THYROID ENLARGEMENT

A

HYPOTHYROIDISM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

AUTOMIMUNE DESTRUCTION OF THYROID

A

HASHIMOTOS THYROIDITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

IMPAIRED SYNTHESIS OF T4 DUE TO ENZYME DEFICIENCY

A

DYSHORMONOGENESIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

MANAGEMENT OF HYPOTHYROIDISM
MOST SATISFACTORY PREP

A

LEVOTHYROXINE

49
Q

T OR F
Higher thyroxine requirements in patients with Celiac Disease and H. pylori gastritis

50
Q

CAN TYROSINE BE ADMINISTERED IN AN EMPTY STOMACH?

51
Q

THYROXINE DOSAGE
YOUNG
OLD

A

YOUNG- FULL REPLACEMENT THERAPY
OLD - 50mcg/d

52
Q

in thyroxine usage
in cardiac patients
stop if?

A

THERE IS ANGINA PECTORIS OR CARDIAC ARRYTHMIA

53
Q

● End state of untreated hypothyroidism, a medical
emergency.

A

MYXEDEMA COMA

54
Q

TREATMENT FOR MYXEDEMA COMA

A

LEVOTHYROXINE

55
Q

IN MYXEDEMA COMA
____ IS indicated if the patient has associated adrenal or pituitary insufficiency.

A

IV HYDROCORTISONE

56
Q

HIGH OR LOW
____levels of circulating thyroid hormone actually protect the heart against increasing demands that could result in angina pectoris, atrial fibrillation, or
myocardial infarction.

57
Q

T OR F
CORRECTION OF MYXEDEMA
coronary artery surgery is indicated, it should be
done first, prior to correction of the myxedema by thyroxine administration.

58
Q

HYPOTHYROID WOMEN
OVULATORY OR ANOVULATORY

A

ANOVULATORY

59
Q

HYPOTHYROID PTS
INCREASE OF ____ REQUIRED TO NORMALIZE SERUM TSH LEVEL IN PREGNANCY

60
Q

Thyroxine should also be administered apart from prenatal vitamins and calcium by at least ____ HRS

61
Q

MAINTENANCE OF TSH FOR PREGNANT

A

○ First trimester: 0.1–2.5 mIU/L
○ Second trimester, 0.2–3.0 mIU/L
○ Third trimester: 0.3–3.0 mIU/L

62
Q

● An elevated TSH level and normal thyroid
hormone levels.

A

SUBCLINICAL HYPOTHYROIDISM

63
Q

Treating with levothyroxine should be individualized based on the risks and benefits of treatment.

A

SUBCLINICAL HYPOTHYROIDISM

64
Q

thyroid hormone therapy should be considered for patients with TSH levels greater than 10 mIU/L while close TSH monitoring is appropriate for those with lower TSH elevations.

A

SUBCLINICAL HYPOTHYROIDISM

65
Q

Also termed as thyrotoxicosis.
● Clinical syndrome that results when tissues are
exposed to high levels of thyroid hormone.

A

HYPERTHYROIDISM

66
Q

● Also known as diffuse toxic goiter.
● Most common form of hyperthyroidism.

A

GRAVES DSE

67
Q

● An autoimmune disorder in which a defect in
suppressor T lymphocytes stimulates B lymphocytes to synthesize TSH receptor–stimulating antibody (TSH-R Ab [stim]) to thyroidal antigens.

A

GRAVES DSE

68
Q

INCREASED T3 AND T4
DECREASE TSH

A

GRAVES DSE

69
Q

MANAGEMENT OF GRAVES

A

Antithyroid Drug Therapy
○ Methimazole and Propylthiouracil.

70
Q

○ Most useful in young patients with small
glands and mild disease.
○ The only therapy that leaves an intact
thyroid gland.
○ Require a long period of treatment and
observation (12-18 months).

A

Antithyroid Drug Therapy
○ Methimazole and Propylthiouracil.

71
Q

○ Preferred than propylthiouracil.
○ Lower risk of serious liver injury.

A

METHIMAZOLE

72
Q

Mild to moderately severe thyrotoxicosis

A

METHIMAZOLE

73
Q

PREFERRED IN PREGNANCY AND THYROID STORM

A

Propylthiouracil (PTU)

74
Q

Inhibits iodine organification, and inhibits the conversion of T4 to T3,

A

Propylthiouracil (PTU)

75
Q

treatment
of choice for patients with very large glands
or multinodular goiters.
○ Patients are treated with antithyroid drugs
until euthyroid (about 6 weeks).

A

THYROIDECTOMY

76
Q

preferred treatment for most patients over 21 years of age.
○ Patients without heart disease

A

RADIOACTIVE IODINE (RAI)

77
Q

IN REGARDS TO RAI
Patients with underlying heart disease or severe thyrotoxicosis and in elderly patients:TREAT WITH

A

METHIMAZOLE

78
Q

_______ should be avoided to ensure maximal 131I uptake.

79
Q

occurs in about 80% of patients following RAI.

A

HYPOTHYROIDISM

80
Q

When hypothyroidism develops,
prompt replacement with ________, 50–150 mcg daily, should be instituted.

A

ORAL LEVOTHYROXINE

81
Q

LARGE GOITER
METHIMAZOLE THEN PTU FOLOWED BY
SUBTOTAK THYROIDECTOMY

A

TOXIC MULTINODULAR GOITER

82
Q

Destruction of thyroid parenchyma with transient release of stored thyroid hormones during the acute phase of a viral infection of the thyroid gland (similar state may occur in patients with Hashimoto’s thyroiditis).

A

SUBACUTE THYROIDITIS

83
Q

IN SUBACUTE THYROIDITIS
SUPPORTIVE THERAPY IS GIVEN IF NOT RESOLVED SPONTY

A

B BLOCKERS (PROPANOLOL)
ASPIRIN OR NSAIDS
CORTICOSTEROIDS

84
Q

KNOWN AS THROTOXIC CRISIS

A

THYROID STORM

85
Q

● Sudden acute exacerbation of all of the symptoms of
thyrotoxicosis, presenting as a life-threatening
syndrome.

A

THYROID STORM

86
Q

MEDS FOR THYROID STORM

A

PROPANOLOL

87
Q

IN THYROID STORM
WHAT MEDS GIVEN IF

control the severe
cardiovascular manifestations.

88
Q

IN THYROID STORM
WHAT MEDS GIVEN IF
ASTHMATIC PATIENT

89
Q

Release of thyroid hormones from the gland is retarded by the administration of

A

POTASIUM IODIDE SATURATED SOLUTION

90
Q

IN THYROID STORM

Hormone synthesis is blocked by the administration OF

A

PROPYLTHIOURACIL

91
Q

IN THYROID STORM IS THERE RECTAL FORMULATION OF PROPYLTHIOURACIL?

92
Q

IN THYROID STORM RECTAL EXAM

A

METHIMAZOLE

93
Q

IN THYROID STORM

protect the patient against shock and will block the conversion of T4 to T3, rapidly reducing the level of thyroactive material in the blood.

A

HYDROCORTISONE

94
Q

IN THYROID STORM

essential to control fever, heart failure, and any underlying disease process

A

SUPORTIVE THERAPY

95
Q

IN THYROID STORM

been used to lower the levels of circulating thyroxine.

A

oral bile acid sequestrants(eg,cholestyramine), plasmapheresis, or peritoneal dialysis

96
Q

Ideally, women in the childbearing period with severe disease should have definitive therapy with __ AND __ prior to pregnancy in order to avoid an acute exacerbation of the disease during pregnancy or following delivery

A

IODINE 131
SUBTOTAL THYROIDECTOMY

97
Q

If thyrotoxicosis does develop during pregnancy,
WHAT is contraindicated because it crosses the placenta and may injure the fetal thyroid.

A

RADIOACTIVE IODINE

98
Q

IN PREGNANCY DURING THYROTOXICOSIS
WHAT IS THE PREFERRED TX

A

PROPYLTHIOURACIL - FIRST TRIMESTER
METHIMAZOLE - REMAINDER PREGNANCY

99
Q

subtotal thyroidectomy can be safely performed during the

A

MID TRIMESTER OR
2ND TRIMESTER

100
Q

may occur in the newborn infant, due either to passage of maternal TSH-R Ab [stim] through the placenta, stimulating the thyroid gland of the neonate, or to genetic transmission of the trait to the fetus.

A

NEONATAL GRAVE’S DISEASE

101
Q

NEONATAL GRAVE’S DISEASE
INCR OR DEC
T3 AND T4
TSH

A

T3 AND T4 - INCREASED
TSH - DECREASED
——————NORMAL INFANT INCREASED TSH

102
Q

NEONATAL GRAVE’S DISEASE
THERAPTY OR MANAGEMENT

A

PROPYLTHIOURACIL
LUGOLS SOLUTION
PROPRANOLOL

103
Q

NEONATAL GRAVE’S DISEASE
IF INFANT IS VERY ILL GIVE

A

ORAL PREDNISONE

104
Q

Defined as a suppressed TSH level (below the normal range) in conjunction with normal thyroid hormone levels.

A

SUBCLINICAL HYPERTHYROIDISM

105
Q

Approximately 3% of patients receiving Amiodarone will develop hyperthyroidism.

A

AMIODARONE-INDUCED THYROTOXICOSIS

106
Q

AMIODARONE-INDUCED THYROTOXICOSIS

  • Often occurs in persons with underlying thyroid disease (eg, multinodular goiter, Graves’ disease)
  • Treatment: therapy with
    thioamides (methimazole)
A

IODINE INDUCED - TYPE 1

107
Q

AMIODARONE-INDUCED THYROTOXICOSIS

  • Occurs in patients without thyroid disease due to leakage of thyroid hormone into the circulation.
  • Treatment: can give anti-inflammatory drugs, responds best to glucocorticoids.
A

INFLAMMATORY THYROIDITIS - TYPE 2

108
Q

IN AMIODARONE -INDUCED THYROTOXICOSIS
OFTEN ADMINISTERED TOGETHER

A

THIOAMIDES
GLUCOCORTICOIDS

109
Q

A syndrome of thyroid enlargement without excessive thyroid hormone production.

A

NONTOXIC GOITER

110
Q

● Enlargement is often due to TSH stimulation from inadequate thyroid hormone synthesis.

A

NONTOXIC GOITER

111
Q

Most common cause of nontoxic goiter worldwide is

A

IODIDE DEFICVIENCY

112
Q

Most common cause of nontoxic goiter IN US

A

HASHIMOTOS THYROIDITIS

113
Q

Managed by prophylactic administration of iodide.
● The optimal daily iodide intake is 150–200 mcg.
● Iodized salt and iodate used as preservatives in
flour and bread are excellent sources of iodine in the
diet.

A

GOITER DUE TO IODIDE DEFICIENCY

114
Q

● Managed by elimination of the goitrogen or by adding sufficient thyroxine to shut off TSH stimulation.

A

GOITER DUE TO INGESTION OF GOITROGENS IN THE DIET

115
Q

Adequate thyroxine therapy—_______—will suppress pituitary TSH and result in slow regression of the goiter as well as correction of hypothyroidism.

A

150–200 mcg/d orally

116
Q

NOT RECOMMENDED FOR BENIGN LESIONS OR ADENOMAS

A

LEVOTHYROXINE

117
Q

Requires a total thyroidectomy, postoperative
radioiodine therapy in selected instances

A

THYROID CARCINOMA

118
Q

lifetime replacement with levothyroxine

A

THYROID CARCINOMA

119
Q

can produce comparable TSH elevations without discontinuing thyroxine and avoiding hypothyroidism.

A

recombinant human TSH (Thyrogen) - IM

PHARMACOLOGY (2nd year) (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions