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1 Pharmacology > Endocrine - Thyroid Disorders > Flashcards

Endocrine - Thyroid Disorders Flashcards

1
Q

Hypothyroidism

aka myxedema coma

A

-low T3 + T4
“everything down except weight”
wt gain, slow metab, low energy, low temp, etc

more common than hyperthyroid

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2
Q

Hyperthyroidism

aka thyroid storm

A

“everything up except weight”
wt loss, high metab, high energy, high temp, INSOMNIA, incr hrt rt, HTN, seizures, dysrhythmias, tremors
-exophthalmos, grave’s disease

harder to treat than hypothyroid

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3
Q

euthyroid

A

normally functioning thyroid

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4
Q

common problem with medicating hypothyroid meds?

A

underdosage - hypo
overdosage - hyper

-takes a while to achieve homeostasis

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5
Q

treatment for

hypo vs hyperthyroidism

A

hypo - hormone replacement

hyper - hormone antagonist

  • ——— destruction of thyroid
  • ——— surgery to remove
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6
Q

levothyroxine

A

levo has 4 letters > T4

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7
Q

levothyroxine

MOA

A

hormone replacement

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8
Q

levothyroxine

CI

A
  • following an MI
  • caution w angina
  • CAD
  • Tx of obesity
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9
Q

levothyroxine

indication

A
  • lab values

- may have goiter

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10
Q

*levothyroxine

A/E

A

HYPERhyroid s/s

INSOMNIA, incr HR, HTN, seizures, dysrhythmias, tremors, nervous, wt loss, diaphoresis, headache, irritability

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11
Q

levothyroxine

Interactions

A
  • incr anticoag effect (warfarin)

- incr insulin req

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12
Q

*levothyroxine

admin

A

PO pill
**30-60 mins in AM b4 breakfast
(first thing in AM to prevent insomnia)

  • can crush mix w water
  • don’t take w Soy Isoflavones
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13
Q

*levothyroxine

RN/teaching

A
  • full effect/PEAK takes 4-8wks
  • DO NOT stop abruptly
  • HOLD if HR>110
  • dose gradually incr
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14
Q

treatment options for hyperthyroid

A

1 medical therapy

2 surgical therapy

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15
Q

surgical therapy for hyperthyroidism

A
  • unresponsive to drug therapy
  • large goiters/tumor causing tracheal compression
  • malignancy
  • emergency
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16
Q

medical therapy options for hyperthyroidism

A

1 thionamides (anti thyroid drugs)
2 I-131 (radioactive iodine therapy)
3 B-adrenergic blockers (adjunt meds)
4 Lugol’s Soln (iodine)

17
Q

treatment of choice in NON-PREGNANT adults w hyperthyroidism

A

Radioactive I-131 “Iodotope”

  • postTx, usually hypo - will need lifelong replacement
  • requires radiation precautions
18
Q

Radioactive I-131
“Iodotope”
MOA

A

-uptaken by thyroid cells>

damages/destroys thyroid tissue

19
Q

*Radioactive I-131
“Iodotope”
CI

A
  • category X
  • no young children
  • no breastfeeding
  • shellfish/sulfite allergy
20
Q

Radioactive I-131
“Iodotope”
indication

A
  • thyroid cancer

- med non-responders

21
Q

Radioactive I-131
“Iodotope”
A/E

A
  • sore throat
  • bone marrow depression (pancytopenia)
  • radiation sickness (hematemesis, epistaxis,, N/V)
  • HYPO
  • dysgeusia
22
Q

Radioactive I-131
“Iodotope”
interactions

A

w lugol’s soln + iodine soln

23
Q

*Radioactive I-131
“Iodotope”
admin

A
  • client secretion will be radioactive until Iodine decays
  • TDS (time, distance, shielding)
  • drink LOTS of water after admin
24
Q

*Radioactive I-131
“Iodotope”
RN/teaching

A
  • 6 ft distance
  • isolate/limit contact to 30 min/day
  • don’t prep food, share utensils
  • incr fluid intake
  • careful disposal
25
Q

methimazole, PTU

A

class: thionamides

26
Q

methimazole, PTU

MOA

A
  • blocks synth of thryoid hormones

- -blocks T3 fr converting to T4

27
Q

methimazole, PTU

CI

A
  • lactation/breastfeeding

- other Iodine products

28
Q

*methimazole, PTU

Indication

A
  • Euthyroid state before/after surgery
  • before surgery, PTU given + B blocker
  • usually given when levo was unsuccessful
29
Q

*methimazole, PTU

A/E

A

HYPO s/s
-drowsy, deprssn, wt gain, edema, bradycrda, cold intolerance, low BP, pancytopenia/agranulocytosis

PTU is hepatoxic

30
Q

methimazole, PTU

interactions

A

anticoag

31
Q

methimazole, PTU

admin

A

w/meals

-consistent time each day

32
Q

methimazole, PTU

RN/teaching

A
  • monitor wt
  • careful w female
  • full effect/peak 3-12 wks
  • avoid consumption of shellfish + high iodine food
33
Q

*when administrating methimazole or PTU, always monitor for ____

A

Brady, sore throat, fever

34
Q

Lugol’s Soln

MOA

A

inhibits synt of T3 + T4

—-for short term treatment only

35
Q

Lugol’s Soln

RN/teaching

A

can stain teeth

  • sip w straw
  • PC meals (prevent GI upset)
  • assess moral mucosa for irritation

1 Pharmacology (33 decks)

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