Endocrine Part 3-Thyroid.ppt Flashcards
Drugs to treat HYPOTHYROIDISM
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
a. Levothyroxine
c. Liothyronine
e. Desiccated thyroid
Drugs to treat HYPERTHYROIDISM/ Anti-Thyroid Drugs
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
b. Methimazole
d. Propylthiouracil (PTU)
This occurs when your thyroid gland produces too much of the hormone thyroxine?
a. Euthyroid
b. Hypothyroidism
c. Hyperthyroidism
d. Thyroid Stimulating Hormone (TSH)
e. Thyroxine (T4)
f. Triiodothyronine (T3)
c. Hyperthyroidism
This is when the thyroid gland does not produce enough thyroid hormones to meet the needs of the body?
a. Euthyroid
b. Hypothyroidism
c. Hyperthyroidism
d. Thyroid Stimulating Hormone (TSH)
e. Thyroxine (T4)
f. Triiodothyronine (T3)
b. Hypothyroidism
This is having a normally functioning thyroid gland.
a. Euthyroid
b. Hypothyroidism
c. Hyperthyroidism
d. Thyroid Stimulating Hormone (TSH)
e. Thyroxine (T4)
f. Triiodothyronine (T3)
a. Euthyroid
With Thyroxine (T4) and Triiodothyronine (T3), what do the 3 and 4 mean Number of ? a. Calcium b. Glucose c. Iodine
c. Iodine
Think Thyroid Hormone like ? , but helps you grow and mature.
a. Epinephrine
b. Adrenaline
Adrenaline
Thyroxine (T4)
a. Longer half life ~ 7 days
b. Shorter half life ~ 1 day
c. Potent (3-4 times more potent than other
d. Pro-hormone (low potency)
a. Longer half life ~ 7 days
d. Pro-hormone (low potency)
Triiodothyronine (T3)
a. Longer half life ~ 7 days
b. Shorter half life ~ 1 day
c. Potent (3-4 times more potent than other
d. Pro-hormone (low potency)
b. Shorter half life ~ 1 day
c. Potent (3-4 times more potent than other
1 Which covert ? in the body? 2 And which of them would you give a Hypothyroidism? 3 Which is an higher ratio? a. Triiodothyronine (T3) b. Thyroxine (T4)
1 b. Thyroxine (T4) - a. Triiodothyronine (T3)
2 b. Thyroxine (T4)
3 2 b. Thyroxine (T4)
Which is the gold standard for test Thyroid Levels/
a. Triiodothyronine (T3)
b. Thyroxine (T4)
c. Thyroid Stimulating Hormone (TSH)
c. Thyroid Stimulating Hormone (TSH)
Thyroid Stimulating Hormone (TSH) ranges
? to ? milliunits/L per
0.3 to 5 milliunits/L per
Which is Hypothyroidism?
a. TSH= 0.2 milliunits/L
b. TSH= 10 milliunits/L
b. TSH= 10 milliunits/L
Which is Hyperthyroidism
a. TSH= 0.2 milliunits/L
b. TSH= 10 milliunits/L
a. TSH= 0.2 milliunits/L
Which drugs cause Hypothyroidism/
a. Levothyroxine
b. Lithium
c. Liothyronine
d. Amiodarone
e. Desiccated thyroid,
b. Lithium
d. Amiodarone
a lack of energy and enthusiasm?
a. Euphoria
b. Lethargy
b. Lethargy
Which is symptoms of Hypothyroidism?
a. Thickened skin
b. Hair loss
c. Diarrhea
d. Constipation
e. Euphoria
f. Lethargy
g. Weight gain
h. Tachycardia
i. Bradycardia
j. Sleepiness
k. Anorexia
a. Thickened skin
b. Hair loss
d. Constipation
f. Lethargy
g. Weight gain
i. Bradycardia
j. Sleepiness
k. anorexia
Thyroid drugs do not work the same way as endogenous thyroid hormones.
T/F, if not why?
False because they do
These drugs are used for the rest of the patient’s life.
T/F, if not why?
True
This is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related too slowing of function in multiple organs.
a. Angina
b. Myxedema coma
b. Myxedema coma
Which Treats all forms of hypothyroidism?
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
a. Levothyroxine
Which treats Myxedema Coma?
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
a. Levothyroxine
Which is simply synthetic T4 (thyroxine) & body will store and convert to T3 in ratios/
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
a. Levothyroxine
A type of chest pain caused by reduced blood flow to the heart?
a. Angina
b. Myxedema coma
a. Angina
Levothyroxine (T4), Liothyronine (T3) and Desiccated Animal Thyroid (T4:T3 ratio)- Adverse Side effects H E A R T
H Heat intolerance E Excitement (insomnia) A Angina R Restless T Tachycardia/Tremor
FDA recommends not to use Levothyroxine (T4) as treatment for ?
a. Diabetes mellitus
b. Obesity/weight loss
b. Obesity/weight loss
If you use Levothyroxine (T4) for Obesity/weight loss which are adverse side effects.
a. Dysrhythmia
b. Arrhythmia
c. Atrial fibrillation
a. Dysrhythmia
c. Atrial fibrillation
Levothyroxine (T4)
ADMINISTRATION
1 This drug requires a/n (Full or Empty) stomach (acidic pH)
2 Give first thing in the (Morning or Afternoon)
Hospitals typically give around (0100 or 0600)
Empty
Morning
0600
Levothyroxine (T4)
ADMINISTRATION
This drug can not have ? when being administrated/
Drug or food
Levothyroxine (T4), why this is incorrect?
- Do administer with bile acid sequestrants (cholestyramine) separate by 1 hours
- Danger with other parasympathomimetic drugs
- Can decrease the effects of warfarin (bleeding risk!)
- Do not administer with bile acid sequestrants (cholestyramine) separate by 4 hours
- Danger with other sympathomimetic drugs (adrenaline)
- Can increase the effects of warfarin (bleeding risk!)
Levothyroxine (T4)
Correct statements?
1. Educate patients that it will take two weeks to notice improvement (we generally check levels around 1-2 weeks after starting)
- Start with high dosage.
- Educate patients that it will take several weeks to notice improvement (we generally check levels around 4-6 weeks after starting)
- Start with low dosage.
Levothyroxine (T4)
Correct statements?
1 This drug acts like a Acetylcholine- some patients report decreased alertness- imagine taking before bed
This drug acts like a catecholamine- some patients report increased alertness- imagine taking before bed
Levothyroxine (T4) is or isn’t a NARROW THERAPEUTIC INDEX drug? (Is or Isn’t)
Is
Whats true about Levothyroxine (T4)?
a. Narrow Therapeutic drug
b. Can switch between brands
c. Can not swish between brands
d. Can be swish with generic version of the same brand.
a. Narrow Therapeutic drug
c. Can not swish between brands
d. Can be swish with generic version of the same brand.
Used when someone has an issue converting to T4 to T3
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
c. Liothyronine
Used for hypothyroidism
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
e. Desiccated thyroid
Some patients prefer a more “Natural” Route
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
e. Desiccated thyroid
Not recommended by Leading Associations
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
e. Desiccated thyroid
is an immune system disorder that results in the overproduction of thyroid hormones.
a. Thyroid storm
b. Graves’ disease
b. Graves’ disease
is a life-threatening health condition that is associated with untreated or undertreated hyperthyroidism.
a. Thyroid storm
b. Graves’ disease
a. Thyroid storm
Thyroid storm & Graves’ disease are
a. HYPERTHYROIDISM
b. HYPOTHYROIDISM
a. HYPERTHYROIDISM
Is HYPERTHYROIDISM adverse side effects the same as Levothyroxine, Liothyronine, Desiccated thyroid - HEART?
Yes or No
Yes
What does treat HYPERTHYROIDISM
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
b. Methimazole
d. Propylthiouracil (PTU)
What are Methimazole + Propylthiouracil (PTU) what condition requires Beta-blocker?
a. Thyroid storm
b. Graves’ disease
c. HYPOTHYROIDISM
a. Thyroid storm
Which drug prevents tyrosine from iodinating in the thyroid to create Thyroxine (T4) to Triiodothyronine (T3)
a. Levothyroxine
b. Methimazole
c. Liothyronine
d. Propylthiouracil (PTU)
e. Desiccated thyroid
b. Methimazole
d. Propylthiouracil (PTU)
A rare, usually develops in first 2 months of therapy: fever, sore throat?
a. Kidney and Bone Marrow Suppression
b. Liver and Bone Marrow Suppression
c. High ALT AST
d. Low ALT AST
e. Hepatotoxicity
f. Nephrotoxicity
g. Agranulocytosis
g. Agranulocytosis
What are Methimazole & Propylthiouracil (PTU) Adverse side effects
a. Kidney and Bone Marrow Suppression
b. Liver and Bone Marrow Suppression
c. High ALT AST
d. Low ALT AST
e. Hepatotoxicity
f. Nephrotoxicity
g. Agranulocytosis
b. Liver and Bone Marrow Suppression
c. High ALT AST
e. Hepatotoxicity
g. Agranulocytosis
Patients on Antithyroid Drugs: Methimazole + PTU drugs should ? high iodine diet.
a. Keep
b. Avoid
b. Avoid
Example of food a patient with Methimazole + PTU drugs should avoid or limit? a Seafood, b. Hot sauce c. Beans d. Soy sauce e. Tofu f. Pepper g. Iodized salt
a Seafood,
d. Soy sauce
e. Tofu
g. Iodized salt
Which is true about Antithyroid Drugs: Methimazole + PTU ADMINISTRATION
a. Doesn’t need to be given with food
b. Better tolerated when given with food
c. Doesn’t need tp be given same time each day to maintain consistent blood levels.
d. Give at the same time each day to maintain consistent blood levels.
e. Never stop these medications abruptly.
b. Better tolerated when given with food
d. Give at the same time each day to maintain consistent blood levels.
e. Never stop these medications abruptly.
