Hyperthyroids Medicatins Flashcards
MOA of methimazole or propylthiouracil (PTU)
Inhibits the thyroid hormone synthesis
Adverse effects of methimazole
Propythiouracil
Agranulocytosis and hypothyroidism
Contraindications PTU methimazole
Allergy to thioamides, impaired liver function , pregnancy
What can you teach with methimazole or propythiouracil (PTU)
Both taken with food and do not stop taking abruptly
Which med can be taken during pregnancy?
PTU can be alright but if you can get away with not taking it you would
Which med is especially hard on the liver
PTU
Hyperthyroid medications
Methimazole
Propythiouracil (PTU)
If you are experiencing hypothyroidism while taking hyperthyroid medications
You are taking too much
If you are taking hyperthyroidism medications and still experiencing hyperthyroidism
You are taking too little
What should you LABS monitor with PTU
Thyroid and liver function tests, PT INR (clotting) & CBC
What do assess with PTU
Vital signs and weights
PTU pt teaching
Report fever sore throat, unusual bleeding (effects clotting ability)
Take medication at the same time of day w meals or snack - space doses
Signs of hypo and hyper thyroid
Do not stop abruptly
What two things should you avoid with hyperthyroidism
Decongestants and diet pills
Radioactive Iodine (I131)
MOA
destroys thyroid cells at high doses
Taking enough iodine radioactive thyroid will be destroyed (safe for other parts of the body)
Used for hyperthyroidism and for thyroid cancer
Used preop to get thyroid a lot smaller
Can be treated at home
Can also be used to shrink the size of thyroid to cut down on possibility of metastasis
Adverse effects of radioactive iodine I131
Radiation sickness, bone marrow suppression hypothyroid
Contraindication of radioactive iodine i131
Pregnancy , young children
Can damage babies thyroid
Dosage for radioactive iodine
4-10 mCi orally
What do we expect with iodine radioactive
Hypothyroid
But we do not want to go to fast
Prep work before iodine radioactive
Private bedroom and own bath room and avoid contact with other people
Pt teaching for iodine radioactive
Monitor CBC
Use private toilet / flush twice
Bathe daily and use frequent hand washin
Use disposable utensils
Sleep alone and avoide pro longed intimate contact 3-4 days
Launder linens , towels, clothes daily and seperatly
Avoid coughing and expectoration
Other hyperthyroidism treatment
Strong iodine solution - non radioactive
MOA of strong iodine solution -no radioactive
Reduces iodine uptake inhibits thyroid hormone production and blocks release of t3 and t4
Adverse effect of strong iodine nonradioactive
Iodism
Toxicity
Looking for metallic taste of the mouth, complains of irritation inside of mouth , sore tooth and gums, mouth ulcers , can also cause swelling in upper throat area
What can we mix iodine solution non radioactive with?
Juice (not so good to drink)
Dosage of nonradioactive iodine
2-6 drops 3 x a day for 10 days
Same time every day
Teachings for strong non radioactive iodine
Teach
Dilute meds in juice
Avoid foods high in iodine(watch for signs of under and overdosing)
Take med same time everyday
Increase fluid intake
What is our goal/when treating hyperthyroidism?
More balance lab results
What are signs of underdosing with strong iodine
Losing weight
What do we monitor w strong iodine non radioactive
Monitor for signs of iodism
VS, weight, I&O
