Endocrine (Thyroid) Drugs

Question 1

Hypothyroidism

Answer 1

Signs: changes in facial expression, cold/dry skin, brittle hair, hair loss, low HR, hypothermia, lethargy, intolerance to cold, constipation, weight gain
Cause: chronic autoimmune thyroiditis (Hashimoto’s disease)

Question 2

levothyroxine (synthroid, levoxyl, levothroid)

Answer 2

-hypothyroidism
Indications: half life 7 days, goiter, cretinism, myxedema
Side effects: thyrotoxicosis (tachy, angina, tremor, nervousness, insomnia, hyperthermia, heat tolerance, sweat)
Contraindication: low absorption, aluminum antacid, iron supplements
Implication: Take on empty stomach 30 minutes before breakfast

Question 3

Hyperthyroidism

Answer 3

-Grave’s disease
Signs: high HR, dysrhythmia, angina, muscle weakness, high BMR, hyperthermia, intolerance to heat, warm/moist skin, weight loss, increase in appetite, protruding eyes
Treatment: surgical removal of thyroid, ablation of thyroid, with radioactive iodine, anti-thyroid drugs

Question 4

methimazole (Tapazole)

Answer 4

Side effect: rash, agranulocytosis

Contraindication: fetal craniofacial malformation

Question 5

propylthiouracil (PTU)

Answer 5

Indication: pre-op suppression gland, thyrotoxic crisis
Side effects: agranulocytosis, hypothyroidism
BLACK BOX WARNING: LIVER INJURY/FAILURE

Question 6

Radioactive iodine

Answer 6

Indication: destroy thyroid tissue
Advantage: low cost, low risk, avoid surgery
Con: Delay 2-3 months, perm. hypothyroidism, precaution after use for all body excretions

Question 7

iodine solution (Lugol’s solution)

Answer 7

• suppress effect on thyroid before surgery

- can be toxic