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Drugs for Thyroid Disease Flashcards

(63 cards)

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1
Q

Posterior Lobe produces?

A

ADH and Oxytocin

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2
Q

where is the thyroid located?

A

anterior of the neck

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3
Q

what do thyroid hormones regulate?

A

oxygen use & basal metabolic rate, cellular metabolism and growth & development

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4
Q

Calcitonin function

A

helps to regulate calcium homeostatsis

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5
Q

Order of thyroid release starting from the hypothalamus to the release of thyroid cells

A 
hypothalamus
thyroid releasing hormone
Anterior pituitary
Thyroid stimulating hormone
thyroid
t3 & t4
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6
Q

chronotropic

A

increasing the rate of occurrence (example heart beat)

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7
Q

catabolic

A

complex substances are converted into smaller ones

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8
Q

TSH is used to screen for what?

A

hypo and hyperthyroidism

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9
Q

free t4 and free t3 can confirm which diagnosis?

A

hyper or hypothyroidism

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10
Q

hypothyroid s/s

A

pale puffy face, cold dry skin, brittle hair, lethargy, low HR and temp

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11
Q

hyperthyroid s/s

A

heart palpitations, fatigue, heat intolerance, irritability

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12
Q

myxedema is seen in hypo or hyperthyroid?

A

hypo

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13
Q

cretinism in infancy is the cause of hypo or hyper in pregnancy?

A

hypo

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14
Q

what can cause hypothyroidism?

A

removal of thyroid, malfunction of thyroid, Hashimoto disease, not enough iodine

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15
Q

During pregnancy, hypothyroidism can cause what problems in the baby during the first trimester

A

permanent neuropsychologic deficits

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16
Q

is hypothyroidism permanent or transient in infants?

A

it can be both

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17
Q

Levothyroxine (t4) and Liothyronie (t3) are meds for hypo or hyper?

A

hypo

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18
Q

Graves disease is a form of hyper or hypo?

A

hyper

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19
Q

expohthalmos is an effect of which disease?

A

graves/ hyper

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20
Q

how do you treat hyperthyroidsm?

A

surgery, beta blockers (to manage symptoms), nonradioactive iodine,

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21
Q

cure for toxic nodular goiter (Plummer disease)? and is it a cause of hyper or hypothyroid?

A

remove thyroid/hyper

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22
Q

Thyrotoxic crisis (thyroid storm) is caused by hypo or hyperthyroid?

A

hyper

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23
Q

s/s of Thyrotoxic crisis (thyroid storm)

A

hyperthermia (105 or higher), restlessness, severe tachycardia, hypotension

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24
Q

treatment of thyrotoxic crisis (thyroid storm)

A

methimazole, beta blocker, sedation, cooling, steriods, IV fluids

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25
How long does Levothyroxine (Synthroid) take to work?
1 month
26
Levothyroxine (Synthroid) side effects
tachycardia, angina, tremors
27
which drugs does Levothyroxine (Synthroid) interfere with and how?
increases effects of warfarin and decreases synthroid absorption H2 blockers, PPIs will reduce Synthroid absorption decreases insulin absorption so watch BS levels
28
When should you give an H2 blockers, or PPIs with Levothyroxine (synthroid)?
4 hours apart
29
before starting treatment of hypothyroidism what do you need to restore first?
adrenal function
30
hypothyroidism atypical presentation in geriatrics
CHF
31
how is absorption affected with geriatrics with thyroid medications?
its increased so start low
32
when can therapy stop for congenital hypothyroidism?
4-8 weeks after the 3rd birthday
33
children and pregnancy may require higher or lower doses of thyroid replacement?
higher
34
Is thyroid replacement ok in pregnancy>
yes, minimal excretion in breast milk
35
when should you be careful about using thyroid replacement therapies?
after an MI, untreated thyrotoxicosis, adrenal insufficiency, hypersensitivity
36
what happens if there is adrenal insufficiency and thyroid replacements are given?
it will precipitate crisis
37
What do you do if patient has toxicity from thyroid drugs?
DC for 5-7 days then restart at a low dose
38
when should you evaluate thyroid therapy during pregnancy?
8 weeks and 6 month gestation
39
after euthyroid has been achieved with thyroid replacement, how often do you evaluate levels?
annually
40
How often do you evaluate thyroid levels until euthyroid is achieved?
6-8 weeks
41
which thyroid disease causes a goiter?
graves (hyper)
42
first line drug for hyperthyroidism
methimazole (Tapazole)
43
which hyperthyroid drug does not destroy existing store of thyroid hormone, does not cause liver damage associated with PTU?
Methimazole (Tapazole)
44
How long after taking Methimazole (Tapazole), does it take to reach a euthyroid state?
3-12 weeks
45
side effect of Methimazole (Tapazole)
Agranulocytosis (decrease in the number of infection fighting granulocytes)
46
when do you use Methimazole (Tapazole) (4)
- graves disease - in conjunction with radiation therapy until radiation therapy becomes efficient - when you need to supress thyroid hormones in order to prepare for thyroid surgery - thyrotoxic crisis
47
Propylthiouracil (PTU) is used for hyper or hypo?
hyper
48
Propylthiouracil (PTU) action
inhibits thyroid hormone synthesis
49
how long does Propylthiouracil (PTU) take to work?
6-12 months
50
Propylthiouracil (PTU) adverse effects
can cause severe liver damage
51
Propylthiouracil (PTU) vs Methimazole
PTU has shorter half life, PTU can cause severe liver damage, methimazole worse for pregnancy, PTU clocks T4 to T3 conversion
52
mild hyperthyroid dosing for Methimazole
15mg/day in dividided doses q8 hrs
53
mild hyperthyroid dosing for PTU
300-400mg/day in divided doses q8-12 hr
54
Moderate hyperthyroid dosing for Methimazole
30-40mg/day
55
severe hyperthyroid dosing for methimazole
60mg/day
56
severe hyperthyroid dosing for PTU
400 mg/day
57
why is nonradioactive iodine used
to suppress thyroid function in preparation for thyroidectomy
58
adverse effects of nonradioactive iodine
brassy taste, burning sensation in mouth, sore teeth, frontal headache, coryza, salivation
59
Thyroid suppressants have what kind of effect on warfarin?
its decrease
60
what types of foods should hyperthyroid patients avoid?
foods high in iodine, seafood, iodized salt
61
If TSH is elevated during thyroid suppressant therapy what do you need to do?
lower dose
62
how often do you monitor thyroid suppressant therapy in an infant? 1-3 year old? >3 years old?
2 months, 2-3 months, 3-12 months
63
what is the outcome evaluation of thyroid suppressant therapy based on?
TSH and free T4 levels

Pharm (33 decks)

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