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Endocrine Exam > Drugs for Thyroid Disease > Flashcards

Drugs for Thyroid Disease Flashcards

1
Q

What are some thyroid agents?

A
  • Levothyroxine (T4)
  • Liothyronine (T3)
  • Liotrix (4:1 ratio of T4:T3)
  • Thyroid desiccated
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2
Q

What are some anti-thyroid agents?

A
  • Radioactive iodine
  • Potassium iodide
  • Methimazole
  • Propylthiouracil (PTU)
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3
Q

What is a better thyroid hormone?

A
  • T3

- T4 is a reserved version of T3

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4
Q

What do thiocyanate and perchlorate do in the biosynthesis of thyroid hormones?

A
  • Common environmental pollutants
  • Disrupt normal thyroid function and reduce the uptake of iodine
  • Competitive inhibition of uptake at the sodium-iodide symporter
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5
Q

What does propranolol do in thyroid storm?

A
  • Inhibits conversion of T4 to T3

- May reverse reduced systemic vascular resistance

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6
Q

What can amiodarone cause?

A
  • Type II amiodarone induced thyrotoxicosis occurs from actual thyroid tissue destruction
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7
Q

What is needed from patients when they start on amiodarone?

A
  • Baseline measures of TSH, free T3, and T4

- Repeat every 6-12 months

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8
Q

What is amiodarone used for?

A
  • Arrhythmias
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9
Q

How does amiodarone cause thyrotoxicosis?

A
  • Each 200mg tablet of amiodarone has 7.4 mg of iodine that is released
  • Daily recommendation is 0.15 mg
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10
Q

What is type I amiodarone induced thyrotoxicosis?

A
  • Patients with underlying thyroid pathology such as autonomous nodular goiter or Graves’ disease
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11
Q

What is type II amiodarone induced thyrotoxicosis?

A
  • Result of amiodarone causing a subacute thyroiditis with release of preformed thyroid hormones into circulation
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12
Q

When is methimazole use?

A
  • When thyroid gland produces excess thyroid hormone

- Usually before thyroid surgery

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13
Q

What does methimazole block?

A
  • Iodide organification
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14
Q

What are some side effects with methimazole?

A
  • Agranulocytosis
  • Leukopenia
  • Thrombocytopenia
  • Aplastic anemia
  • Liver inflammation
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15
Q

Why is methimazole taken before surgery?

A
  • To lower thyroid hormone levels
  • Minimize the effects of thyroid manipulation
  • Inhibits the enzyme thyroperoxidase which catalyzes a necessary step in the synthesis of T3/T4
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16
Q

What is potassium iodide?

A
  • Stable form of iodine

- Blocks iodine uptake

17
Q

What is potassium iodide used for?

A
  • Treatment for hyperthyroidism
  • Treatment for iodine deficiency
  • And used with anti-thyroid meds to prepare thyroid for surgical removal
18
Q

What does potassium iodide do in radiation exposure?

A
  • Protects by shrinking the thyroid gland

- Decreases thyroid hormone production

19
Q

What are the indications of using PTU?

A
  • Patients with Graves’ disease
  • Patients with toxic multi-nodular goiter
  • Intolerant of methimazole
  • Surgery or radioactive iodine therapy is not appropriate
20
Q

What is PTU used for?

A
  • Ameliorate symptoms of hyperthyroidism
  • In preparation of thyroidectomy
  • In radioactive iodine therapy in patients who are intolerant of methimazole
21
Q

What does PTU do?

A
  • Inhibits synthesis of thyroid hormones in hyperthyroidism

- Inhibits the conversion of thyroxine to T3 in peripheral tissues

22
Q

What doesn’t PTU do?

A
  • Inactivate pre-existing T4/T3

- Interfere with the effectiveness of thyroid hormones given by mouth or by injection

23
Q

What is levothyroxine used for?

A
  • Treat thyroid hormone deficiency
24
Q

What is levothyroxine?

A
  • Manufactured T4 which is converted to T3

- Max effect can take up to 6 weeks

25
Q

What are some side effects of levothyroxine?

A
  • Weight loss
  • Trouble tolerating heat
  • Sweating
  • Anxiety
  • Trouble sleeping
  • Tremor
  • Fast HR
26
Q

What are some drugs that impair levothyroxine?

A
  • Antacids
  • Iron
  • Sucralfate- anti-ulcer med
  • Cholestyramine
  • Orlistat
  • PPIs
27
Q

What is radioactive iodine used for?

A
  • Therapy for thyroid cancer since the thyroid gland absorbs iodine
28
Q

Who is radioactive iodine contraindicated in?

A
  • Pregnant women

Endocrine Exam (11 decks)

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