Final thyroid medications Flashcards
emergency intervention for thyroid storm?
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
relative strengths of the hypothyroid drugs
Levothyroxine/synthroid: 100mcg = 60mg Thyroid USP/armor
Levothyroxine/synthroid: 100mcg + 25mcg Liothyronin Cytomel
Drugs for hypothyroid with MOA
Levothyroxine/synthroid: T4, synthetic 100 mcg
Thyroid UPS/Armour: T3/T4, porcine gland: 60mg
Liothyronine/Cytomel: T3, Synthetic, 25 mcg
what is the equivalent of 1 grain
1 grain: 60mg Armur, 100mcg Synthroid, 25mcg Cytomel
caution with hypothyroid drugs in general
They increase advancement of Coronary artery disease and osteoporosis
what is the major caution with Addisons and hyperthyroid
If you don’t want them to die, replace cortisol first
Treatments drugs for Hyperthyroid
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
which thyroid are Category X and Category D
Radioactive iodine, 131 = category X
thionamide: methamazole = Cat D
THionamide: PTU, propylthiouracil = Cat D
MOA thionamides
blocks thyroxine production in thyroid t3/T4: methimazole
Blocks thyroxine production (T3/T4) peripherally: propythiouracil, PTU
scary side effects of methimazole
agranulocytosis…also a bit on PTU
side effects of Non selective beta blocker
Propanolol: fatigue, sedation, impotency, depression
when is the radioactive iodine used
- graves
- cancer
caution with using radioactive iodine to kill thyroid
need to be euthroid first or you can initiate thyroid storm
cautions when using radioactive iodine
Category x - delay pregnancy 6-8 mos
can cause acute leukemia
decrease sperm count.
thyroid facticia
excessive thyroid causes hyperthyroid state
PE findings of graves
exopthalmous and goiter
how long can you give methimazole
only 6 -12 months, agranulocytosis: thionamide
why not oral thionamide for thyroid storme
takes weeks to take affect
thyroid storm
high fever, irritability, delirium, vomit, diarrhea, dehydration , vascular collapse
primary vs secondary vs tertiary
Primary hypo: thyroid
Secondary: pit
Tertiary: hypothalmous
who should you be carefull giving hypothyroid drugs to
those over 65 because of the CAD risk, and those with addisons, remember cortisol first
when would you use T3 cytomel
intolerance to T4
WIlsons syndrome
myxedema coma
