Final thyroid medications

Question 1

emergency intervention for thyroid storm?

Answer 1

IV: Beta blocker, IV thionamide and oras SSKI
IV: Propanolol (beta blocker) PTU or Methamazole( thionamide and oral SSKI
Oral corticosteroids may be used to diminish acute inflammations

Question 2

relative strengths of the hypothyroid drugs

Answer 2

Levothyroxine/synthroid: 100mcg = 60mg Thyroid USP/armor

Levothyroxine/synthroid: 100mcg + 25mcg Liothyronin Cytomel

Question 3

Drugs for hypothyroid with MOA

Answer 3

Levothyroxine/synthroid: T4, synthetic 100 mcg
Thyroid UPS/Armour: T3/T4, porcine gland: 60mg
Liothyronine/Cytomel: T3, Synthetic, 25 mcg

Question 4

what is the equivalent of 1 grain

Answer 4

1 grain: 60mg Armur, 100mcg Synthroid, 25mcg Cytomel

Question 5

caution with hypothyroid drugs in general

Answer 5

They increase advancement of Coronary artery disease and osteoporosis

Question 6

what is the major caution with Addisons and hyperthyroid

Answer 6

If you don’t want them to die, replace cortisol first

Question 7

Treatments drugs for Hyperthyroid

Answer 7

Thionamide: methiamazole : blocks thyroxine production and T3/T4 production in thyroid
Thionamide: PTU, propylthiouricil: blocks thyroxine production: blocks Peripheral conversion T4 to T3
Non selective beta blocker: Propanolol
Elemental iodine: SSKI: inhibit thyroxine release
Radioactive : I131: thyroid destructions

Question 8

which thyroid are Category X and Category D

Answer 8

Radioactive iodine, 131 = category X
thionamide: methamazole = Cat D
THionamide: PTU, propylthiouracil = Cat D

Question 9

MOA thionamides

Answer 9

blocks thyroxine production in thyroid t3/T4: methimazole

Blocks thyroxine production (T3/T4) peripherally: propythiouracil, PTU

Question 10

scary side effects of methimazole

Answer 10

agranulocytosis…also a bit on PTU

Question 11

side effects of Non selective beta blocker

Answer 11

Propanolol: fatigue, sedation, impotency, depression

Question 12

when is the radioactive iodine used

Answer 12

• graves

- cancer

Question 13

caution with using radioactive iodine to kill thyroid

Answer 13

need to be euthroid first or you can initiate thyroid storm

Question 14

cautions when using radioactive iodine

Answer 14

Category x - delay pregnancy 6-8 mos
can cause acute leukemia
decrease sperm count.

Question 15

thyroid facticia

Answer 15

excessive thyroid causes hyperthyroid state

Question 16

PE findings of graves

Answer 16

exopthalmous and goiter

Question 17

how long can you give methimazole

Answer 17

only 6 -12 months, agranulocytosis: thionamide

Question 18

why not oral thionamide for thyroid storme

Answer 18

takes weeks to take affect

Question 19

thyroid storm

Answer 19

high fever, irritability, delirium, vomit, diarrhea, dehydration , vascular collapse

Question 20

primary vs secondary vs tertiary

Answer 20

Primary hypo: thyroid
Secondary: pit
Tertiary: hypothalmous

Question 21

who should you be carefull giving hypothyroid drugs to

Answer 21

those over 65 because of the CAD risk, and those with addisons, remember cortisol first

Question 22

when would you use T3 cytomel

Answer 22

intolerance to T4
WIlsons syndrome
myxedema coma