MCPHS PA Pharmacology Thyroid Drug Info Exam 3

Question 1

What are the Specific Uses of Methimazole?

Hyperthyroid drugs (Thioamides)

Answer 1

Hyperthyroidism

Question 2

What are the Actions of Methimazole?

Hyperthyroid drugs (Thioamides)

Answer 2

Inhibt Iodine incorporation into Thyroglobulin

Question 3

What are the ADRs of Methimazole?

Hyperthyroid drugs (Thioamides)

Answer 3

Hepatotoxic (less risk than PTU)

Question 4

What are the Facts you need to know about Methimazole?

Hyperthyroid drugs (Thioamides)

Answer 4

Drug of choice

Faster onset

Daily Dosing

Preferred post 1rst Trimester

Safe in Lactation

Question 5

What are the Specific Uses of Propylthiouracil (PTU)?

Hyperthyroid drugs (Thioamides)

Answer 5

Hyperthyroidism

Thyroid Storm

Intolerance of methimazole

Question 6

What are the Actions of Propylthiouracil (PTU)?

Hyperthyroid drugs (Thioamides)

Answer 6

Inhibit Iodine incorporation into Thyroglobulin

Blocks Peripheral conversion of T4 to T3

Question 7

What are the ADRs of Propylthiouracil (PTU)?

Hyperthyroid drugs (Thioamides)

Answer 7

Agranulocytosis

Hepatotoxic

Question 8

What are the Facts you need to know about Propylthiouracil (PTU)?

Hyperthyroid drugs (Thioamides)

Answer 8

Preferred in the 1rst Trimester

Safe in Lactation (drug of choice)

Question 9

What are the Specific Uses of Sodium Iodide (I-131)?

Hyperthyroid drugs (Radioactive Iodide)

Answer 9

Measure Thyroid Function

Thyroid Cancer

(Thyroid Ablasion)

Question 10

What are the Actions of Sodium Iodide (I-131)?

Hyperthyroid drugs (Radioactive Iodide)

Answer 10

Mimics Iodide

Gets taken up by thyroglobulin

Question 11

What are the ADR’s of Sodium Iodide (I-131)?

Hyperthyroid drugs (Radioactive Iodide)

Answer 11

Permanant Hypothyroidism

Question 12

What are the Facts do you need to know about Sodium Iodide (I-131)?

Hyperthyroid drugs (Radioactive Iodide)

Answer 12

Takes 4-8 Wks for Symptomatic Relief (w/ablasion)

Question 13

What are the Specific Uses of Lugols solution and SSKI?

Hyperthyroid drugs (Potassium Iodide)

Answer 13

Thyroid Storm

Pre-op thyroidectomy

Question 14

What are the Actions of Lugols solution and SSKI?

Hyperthyroid drugs (Potassium Iodide)

Answer 14

Saturate Thyroglobin w/ Iodine so it stops putting out T3/T4

Question 15

What are the Facts you need to know about Lugols solution and SSKI?

Hyperthyroid drugs (Potassium Iodide)

Answer 15

Will cause an initial spike in T3/T4

Must give with Thiamide to prevent fatal hyperthyroidism

Question 16

What is the Specific Use of Levothyroxine?

Hypothyroid drugs

Answer 16

Hypothyroidism

Question 17

What are the Actions of Levothyroxine?

Hypothyroid drugs

Answer 17

It is Synthetic T4

Question 18

What are the ADRs of Levothyroxine?

Hypothyroid drugs

Answer 18

nausea/vomiting/diarrhea
change in appetite & weight
sweating
headache
insomnia
reduction in bone mineral density (rare)

Question 19

If you Dose Levothyroxine to high what ADRs might you see?

Hypothyroid Drugs

Answer 19

Tachycardia / Angina

-Start with low dose in Cardiac compromise

Question 20

What are the Facts you need to know about Levothyroxine?

Hypothyroid drugs

Answer 20

Take on empty stomach with full glass of water

Seperate Antacids / iron by 4 hrs

Brand/generic bioequivalence issues,

Safe & preferred in pregnancy/lactation

-Assess TSH every 6 weeks while Preggers

Question 21

What is the Specific Use of Liothyronine?

Hypothyroid drugs

Answer 21

Diagnostic tool in T3 Supression test

Question 22

What are the ADRs of Liothyronine?

Hypothyroid drugs

Answer 22

Arrythmia

Tachycardia

Cardiopulmonary Arrest

Hypotension

MI

Question 23

What needs to be monitored while taking Liothyronine?

Hypothyroid Drugs

Answer 23

S/S

TSH

Free T4

BP

HR

Renal

Question 24

What are the Facts you need to know about Liothyronine?

Hypothyroid drugs

Answer 24

Rarely Used in Primary care

Dosing Monitoring involves Endocrinologist

Question 25

What is the specific use of Liotrix? Hypothyroid drugs

Answer 25

Hypothyroidism

Question 26

What is the MOA of Liotrix? Hypothyroid drugs

Answer 26

Combination of T4 and T3 (4:1 ratio)

Question 27

What needs to be monitored while taking Liotrix? Hypothyroid Drugs

Answer 27

Monitor S/S TSH Free T4 BP HR Renal

Question 28

What are the facts you need to know about Liotrix? Hypothyroid Drugs

Answer 28

It's expensive No conclusive benefit over T4 alone Complex dosing Not recommened for use.

Question 29

What are the specific uses of Desiccated Thyroids? Hypothyroid Drugs

Answer 29

Hypothyroidism

Question 30

What are are Desiccated Thyroids? Hypothyroid Drugs

Answer 30

"Natural" thyroid hormone derived from desiccated hog and beef thyroid.

Question 31

What must be monitored on Desiccated Thyroids? Hypothyroid Drugs

Answer 31

S/S TSH Free T4 Hypersensitivity

Question 32

What are the facts you need to know about Desiccated Thyroids? Hypothyroid Drugs

Answer 32

They are unstable There are allergy issues Bioequivalence vary with brand No longer recommended for use

Question 33

What are the DDIs of Thyroid Hormones should we be aware of?

Answer 33

**Antacids** **Calcium** **Al** **Mg**

Question 34

What needs to be monitored on Levothyroxine?

Answer 34

**TSH** (Always) **Free T4** (Sometimes or as Reflex) Free T3 (Uncommon unless called fro by TSH/T4) **Hypothyroid** Signs / Symptoms (S/S) may require Dose up **Hyperthyroid** S/S may require Dose down

Question 35

What can leaving Hypothyroidism untreated in pregnancy lead to?

Answer 35

Increased risk of Maternal HTN Abnormal Fetal Brain Development Spontaneous Abortion Low Birth Weight Fetal Death