Exam 1 Flashcards
- Thyroid Gland Function?
- need sufficient ________ to produce thyroid hormones
- regulates BMR
—>person must obtain a sufficient amount of iodine to produce thyroid hormones
TRH comes from what part of the brain
hypothalamus
TSH comes from what part of the brain
pituitary
T3 and T4 com from what part of the brain
thyroid gland
T4 (storage) is converted to __ (active) at target tissues
T3
thyroid hormones affect what 5 things
- Heat production and body temperature
- oxygen consumption and CO
- BV
- Enzyme system activity
- Metabolism of carbs, fats, and proteins
what hormone is important for regulator of growth and development, especially with reproductive and nervous systems
Thyroid gland
Targert cells absorb thyroid hormone which sends a message to the ___________ to stop sending out more ___, which stops production of ___, then stops T_ and T_
Hypothalamus; TRH; TSH; 3; 4
What is the clinical definition of Hypothyroidism
(__ is converted to __)
Elevated TSH due to insufficient amount of thyroid hormone (T4 is converted to T3)
5 Causes of Hypothyroidism
- low iodine
- low function of thyroid tissue due to tumor or autoimmune disorder (Hashimoto)
- Thyroidectomy
-Aggressive Tx with antithyroid drugs
(Low mineral, No function, autoimmune/tumor, or antithyroid drugs)
Symptoms of Hypothyroidism
- Chills
- low body temp
- Lethargy, slowed speech
- bradycardia, hypotension
- decreased appetite
- weight gain
- skin pale, dry
(LOW AND SLOW)
What are the 2 types of Hypothyroidism
Cretinism (children)
- dwarfism/severe mental retardation
Myxedema (adults)
- Symptoms of normal Hypothyroidism
Hypothyroidism is related to what disease
Graves Disease
What are the symptoms of Hyperthyroidism
- Inc. BMR
- Tachycardia
- Weight loss
- Inc. Body temp
- Anxiety
name of hyperthyroidism symptom of bulge of the eyes
Exophthalmos
What is the drug of use for someone with hypothyroid conditions?
Levothyroxine
What is the drug of use for someone with hyperthyroid conditions?
Thiomides (class)
- Propylthiouracil (PTU)***
- Methimazole (Tapazole)
- Radioactive Iodine
replacement therapy increases the levels of thyroid hormone and this suppresses what hormone?
TSH
How to teach a patient on how to take levothyroxine
used for hypothyroidism
- take with an empty stomach, 30min before breakfast, with full glass of water
why should you be caustious to give levothyroxine to a patient with a cardiac hx
the drug increases HR and BP and can cause complications
Adverse effects of Levothyroxine
ALL SYMPTOMS OF TAKING TOO MUCH
- HTN
- Tachycardia
- Arrhythmia
- Anxiety, nervousness, jittery, inability to sleep
- Heat intolerance
- Sweating
Warfarin interacting with levothyroxine causes what effect
Increased anticoagulant effect
Digoxin interacting with levothyroxine causes what effect
Decreased effect of levothyroxine
Antiseizue and antidepressants interacting with levothyroxine causes what effect
Increase levothyroxine metabolism
Binding Agents interacting with levothyroxine causes what effect
Decrease levothyroxine absorption
Pharmacokinetics of PTU
inhibits synthesis of thyroid hormones; inhibits peripheral conversion of T4 to T3
- well absorbed in GI tract
PTU adverse effects
(4ish effects)
- thyroid suppression; drowsiness, lethargy
- Watch for increase in liver issues/jaundice (HEPATITIS)
-use with anticoagulants causes INCREASED BLEEDING - GI distress, N/V
Mthimazole(tapazole) have similar effects what drug but is associated with what suppression?
PTU
- Bone marrow suppression
Sodium iodide is sued to treat what type of thyroid issue?
Hyperthyroidism
- it is radioactive so it gets absorbed and then destroys thyroid cells
radiation such as soidum iodide is not safe for???
Pregnant or children
Adrenal Medulla is located on the inside or outside?
Adrenal cortex is located on the outside or inside? and what does it produce?
Medulla: Inner core; part of the SNS
Adrenal Cortex: Outer shell; produces hormones called corticosteroids
What includes androgens, glucocorticoids, and mineralcorticoids (this is mainly what)?
Corticosteroids
Mainly aldosterone
Corticotropin (ACTH) stimulates what to produce what
stimulates the adrenal cortex to produce corticosteroids
Incrasing levels of corticosteroids inhibit the release of what and what to start a negative feedback mechanism
increasing levels of corticosteroids inhibits the release of CRH and ACTH - negative feedback loop
sudden stops of steroids results in a crisis of adrenal ___________ until hypothalamic-pituitary axis controls stimulate the ______ _____ again
sudden stops of steroids results in a crisis of adrenal cortex until hypothalamic-pituitary axis controls stimulate the adrenal gland again
a common cause of adrenal insufficiency is prolonged use of what?
corticosteroid hormones
an exogenous use of this product acts to negate the regular feedback loop, what is it?
Corticosteroids
what causes the adrenal glands to no longer be stimulated and produce or secrete hormones?
The use of exogenous corticosteroids
when exogenous corticopsteroids are used, how long does it take fo the adrnal gland to recover from the atrophy of the lack of stimulation
several weeks
Because exogenous corticosteroids can cause atrophy of ACTH hormone release, what is recomennded with the use of steroid therapy
only use for short-term steroid therapy and should be weaned slowly
- this gives the adrenal glands time to recover and start producing hormones again
What steroid is a male and female sex hormone and effect electrolytes, stimulate protein production, and decrease protein breakdown
Androgens
What steroid stimulated an increase in glucose levels for energy
- glucocorticoids have anti-inflammatory properties, help to control metabolism of muscle, fat liver and bone, they effect vascular ton influence mood, behavior, sleep/wake cycle
- primary corticoid is cortisol
glucocorticoids
What steroid affects electrolyte levels and homeostasis
- regulate Na, H2O balance
- primary version of it is aldosterone
Mineralocorticoids
What steroid promotes homeostasis of CV, nervous, and musculoskeletal systems - to a certain extent
Glucocorticoids
What would be the INDICATIONs OF USE for
Adrenal Glands and warnings?
- suppress immune system **
(used mostly for short-term) - short term use: Releace acute inflammation AND for replacement therapy when release of hromone arent adequate
-DOES NOT CURE ANY INFLAMMATORY DISORDERS
What are the TOP 3 glucocorticoid medication names?
Cortisone (generic)
Dexamthasone (generic)
Prednisone (Rayos)
Which glucocorticoid is short acting and what activity does it produce?
Short acting: Cortison: Both glucocorticoid and mineralocorticoid activity
Which glucocorticoid medication is intermediate acting?
Prednisone
Which glucocorticoid medication is long acting?
Dexamethasone
Why are glucocorticoiuds so important (what is their function and use)
they are anti-inflammatory
(anti-inflammatory helps with allergies, rhinitis, asthma, dermatitis, etc.)
- Helps with Maignant disorders (Hodgkin’s disease, leukemias)
- Immunosuppression (Post-transplant surgery)
What is the action of Glucocorticoids/ what does it cause the body to do?
Cause lipogenesis (formation of fat)
- decreases WBC, inhibits tisue granulation and repair
- may cause NA and H2O retention (leading to edema and HTN)
- Opposite of androgens (inc. protein breakdown and dec. rate of protein formation)
Contraindications of glucocorticoids
- allergic
- acute infection
- lactation
Caution with the use of glucocorticoids
- pregnancy
- diabetes
- Acute peptic ulcer
Drug-drug interaction with glucocorticoids
(what drugs increase/decrease it)
- Increase in glucocorticoid function when given erythromycin, ktoconazole or troleandomycin
- Decrease in drug when given with salicylates barbiturates, pehnytoin or rifampin
What is the top adverse effect for the use of glucocorticoids?
Growth retardation in children
What causes Adrenal insufficiency?
Decrease in ACTH from pituitary or decreased output from adrenal cortex
