module 16 hyperthyroid meds

Question 1

thioamines: antithyroid meds

Answer 1

propylthiouracil (PTU)

methimazole

Question 2

thioamines MOA

Answer 2

block organification process by competing for oxidized iodide
-> block formation of MIT and DIT
dec. synthesis of thyroid hormone
PTU: inhibits T4 to T3 conversion in periphery

Question 3

thioamines use

Answer 3

only useful in overproduction of thyroid hormone

Question 4

thioamine AE

Answer 4

goiter
pruritic rash: usually resolves
arthralgias 
RARE but serious: 
- agranulocytosis
- hepatotoxicity: allergic reaction 
- vasculitis: presents as drug induced lupus

Question 5

thioamine admin

Answer 5

onset: 1-2 wk
methimazole: longer half life: daily dose
PTU: short half life: TID dosing

Question 6

propylthiouriacil DI

Answer 6

depletes prothrombin

-> inc. bleeding

Question 7

thioamines EDU

Answer 7

methimazole preferred agent except with
- pregnancy
- thyroid storm
serous AE more likely with PTU

Question 8

thioamines monitoring

Answer 8

WBC at baseline and with any sore throat

Question 9

other hyperthyroid tx

Answer 9

radioactive iodine
B-blockers
iodide
corticosteroids

Question 10

radioactive iodine

Answer 10

thyroid gland ablation

Question 11

beta blockers MOA for thyroid

Answer 11

block hyperadrenergic effects

block T4 -> T3 conversion in periphery

Question 12

beta blocker for thyroid storm

Answer 12

esmolol

Question 13

iodide MOA

Answer 13

blocks peripheral conversion of T4 to T3
promptly and temporarily blocks hormone release
- once all iodide is uptaken, large release will occur

Question 14

corticosteroids MOA with thyroid

Answer 14

blocks peripheral conversion of T4 to T3

suppresses thyroid Rc Ab and inflammation

Question 15

corticosteroids used with hyperthyroid

Answer 15

prednisone

methylprednisolone