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Pharm > Drugs for Thyroid Disease > Flashcards

Drugs for Thyroid Disease Flashcards

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
Q

How long does Levothyroxine (Synthroid) take to work?

A

1 month

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26
Q

Levothyroxine (Synthroid) side effects

A

tachycardia, angina, tremors

27
Q

which drugs does Levothyroxine (Synthroid) interfere with and how?

A

increases effects of warfarin and decreases synthroid absorption
H2 blockers, PPIs will reduce Synthroid absorption
decreases insulin absorption so watch BS levels

28
Q

When should you give an H2 blockers, or PPIs with Levothyroxine (synthroid)?

A

4 hours apart

29
Q

before starting treatment of hypothyroidism what do you need to restore first?

A

adrenal function

30
Q

hypothyroidism atypical presentation in geriatrics

A

CHF

31
Q

how is absorption affected with geriatrics with thyroid medications?

A

its increased so start low

32
Q

when can therapy stop for congenital hypothyroidism?

A

4-8 weeks after the 3rd birthday

33
Q

children and pregnancy may require higher or lower doses of thyroid replacement?

A

higher

34
Q

Is thyroid replacement ok in pregnancy>

A

yes, minimal excretion in breast milk

35
Q

when should you be careful about using thyroid replacement therapies?

A

after an MI, untreated thyrotoxicosis, adrenal insufficiency, hypersensitivity

36
Q

what happens if there is adrenal insufficiency and thyroid replacements are given?

A

it will precipitate crisis

37
Q

What do you do if patient has toxicity from thyroid drugs?

A

DC for 5-7 days then restart at a low dose

38
Q

when should you evaluate thyroid therapy during pregnancy?

A

8 weeks and 6 month gestation

39
Q

after euthyroid has been achieved with thyroid replacement, how often do you evaluate levels?

A

annually

40
Q

How often do you evaluate thyroid levels until euthyroid is achieved?

A

6-8 weeks

41
Q

which thyroid disease causes a goiter?

A

graves (hyper)

42
Q

first line drug for hyperthyroidism

A

methimazole (Tapazole)

43
Q

which hyperthyroid drug does not destroy existing store of thyroid hormone, does not cause liver damage associated with PTU?

A

Methimazole (Tapazole)

44
Q

How long after taking Methimazole (Tapazole), does it take to reach a euthyroid state?

A

3-12 weeks

45
Q

side effect of Methimazole (Tapazole)

A

Agranulocytosis (decrease in the number of infection fighting granulocytes)

46
Q

when do you use Methimazole (Tapazole) (4)

A
  • 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
Q

Propylthiouracil (PTU) is used for hyper or hypo?

A

hyper

48
Q

Propylthiouracil (PTU) action

A

inhibits thyroid hormone synthesis

49
Q

how long does Propylthiouracil (PTU) take to work?

A

6-12 months

50
Q

Propylthiouracil (PTU) adverse effects

A

can cause severe liver damage

51
Q

Propylthiouracil (PTU) vs Methimazole

A

PTU has shorter half life, PTU can cause severe liver damage, methimazole worse for pregnancy, PTU clocks T4 to T3 conversion

52
Q

mild hyperthyroid dosing for Methimazole

A

15mg/day in dividided doses q8 hrs

53
Q

mild hyperthyroid dosing for PTU

A

300-400mg/day in divided doses q8-12 hr

54
Q

Moderate hyperthyroid dosing for Methimazole

A

30-40mg/day

55
Q

severe hyperthyroid dosing for methimazole

A

60mg/day

56
Q

severe hyperthyroid dosing for PTU

A

400 mg/day

57
Q

why is nonradioactive iodine used

A

to suppress thyroid function in preparation for thyroidectomy

58
Q

adverse effects of nonradioactive iodine

A

brassy taste, burning sensation in mouth, sore teeth, frontal headache, coryza, salivation

59
Q

Thyroid suppressants have what kind of effect on warfarin?

A

its decrease

60
Q

what types of foods should hyperthyroid patients avoid?

A

foods high in iodine, seafood, iodized salt

61
Q

If TSH is elevated during thyroid suppressant therapy what do you need to do?

A

lower dose

62
Q

how often do you monitor thyroid suppressant therapy in an infant? 1-3 year old? >3 years old?

A

2 months, 2-3 months, 3-12 months

63
Q

what is the outcome evaluation of thyroid suppressant therapy based on?

A

TSH and free T4 levels

Pharm (33 decks)

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