Ex 3 Thyroid disorders/adrenal

Question 1

Function of thyroid hormones

Answer 1

regulates metabolic rate of all cells
regulates body heat poduction
maintains growth hormone secretion and skeletal maturation
affects CNS development
maintains cardiac rate,force,output
maintains secretion of GI tract
affects respiratory tae and oxygen use
affects RBC producton

Question 2

causes of hypothyroidism

Answer 2

gland malfunction, pituitary tumor, removal of gland, iodine deficinecy

Question 3

s/sx of hypothyroidism

Answer 3

sluggish, tired, poor memory, dry skin, birttle hair and nails, bradycardia, constipation, heavy menses, cold intolerant, weight gain

Question 4

levothyroxine (synthroid) MOA

Answer 4

synthetic T4 converted to T3 to hypothyroidism

Question 5

levothyroxine (synthroid) Pharmacokinetics

Answer 5

oral or IV (mcg)
food interferes with absorption esp. calcium
very highly protein bound = long T1/2
safe in pregnancy

Question 6

levothyroxine (synthroid) adv side effects

Answer 6

overdose is thyrotoxic crisis

Question 7

levothyroxine (synthroid) pt. education

Answer 7

take early AM on empty stomach
generic/brand consistency
regular lab monitoring
report thyrotoxic symptoms

Question 8

Hyperthyroidism causes:

Answer 8

graves disease, toxic nodular goiter

Question 9

hyperthyroidism s/sx

Answer 9

revved up, anxious, poor concentration, hungry, tachycardia, chest pain, hyper defecation, irregular to no menses, heat intolerance, weight loss

Question 10

methimazole & propylthiouracil (PTU) MOA:

Answer 10

treats hyperthyroidism
- thionamides
- inhibit thyroid hormone synthesis
PTU also suppresses conversion of T4to T3 in the body
short or long term use

Question 11

methimazole & propylthiouracil (PTU) pharmacokinetics

Answer 11

PO
slow onset of fects
methimazole has longer T1/2
PTU preferred in pregnancy

Question 12

methimazole & propylthiouracil (PTU) adv. effects

Answer 12

methimazole is teratogenic
too much can cause hypothyroidism

Question 13

methimazole & propylthiouracil (PTU) pt education

Answer 13

frequent lab monitoring required

Question 14

adrenal cortex function

Answer 14

maintain glucose availability (glucocorticoids)
- cortisol

Question 15

corticosteroids protoypes

Answer 15

hydrocortisone or prednisone

Question 16

hydrocortisone or prednisone administration

Answer 16

Oral, IV,IM, rectal, topical

Question 17

hydrocortisone or prednisone absorption

Answer 17

well-absorbed orally

Question 18

hydrocortisone or prednisone metabolism

Answer 18

liver

Question 19

hydrocortisone or prednisone excretion

Answer 19

urine

Question 20

Glucocorticoids physiological levels risk of adverse effects

Answer 20

minimmal:
- glucose for the brain
- protein metabolism
- fat metabolism
- keeps BP in check
- maintains blood cells

Question 21

Glucocorticoids pharmalogical levels risk of adverse effects

Answer 21

higher risk
treats:
allergic rxns
lung conditions
inflammation
dermatologic conditions

Question 22

Addison’s disease aka Adrenal insufficinecy

Answer 22

not enough hormone
chronic adrenocorticoid insufficiency
requires lifelong supplementation with glucocorticoid
needs extra steroid dose during times of physical stress

Question 23

Glucocorticoids pharmacological levels adverse effects

Answer 23

• at higher and longer doses
  hyperglycemia
  muslce atrophy
  fat redistribution
  fluid retention
  adrenal suppression
  osteoperosis
  growth retardation
  peptic ulcers

Question 24

Managing adverse effects of glucocorticoids: hyperglycemia

Answer 24

focus on diet and exercise

Question 25

Managing adverse effects of glucocorticoids: adrenal suppression

Answer 25

taper after long periods

Question 26

Managing adverse effects of glucocorticoids: osteoperosis

Answer 26

wt- bearing exercise, calcium and vit D

Question 27

Managing adverse effects of glucocorticoids: susceptibility to infection

Answer 27

screen and prevent

Question 28

Managing adverse effects of glucocorticoids: psychological problems

Answer 28

educate

Question 29

Managing adverse effects of glucocorticoids: peptic ulcers and hypertension

Answer 29

avoid NSAIDs