Pharm - Hypothyroidism

Question 1

What is the standard therapy for treating hypothyroidism?

Answer 1

levothyroxine

Question 2

what are the two main types of antithyroid agents?

Answer 2

methimazole and propylthiouracil

Question 3

what is the mechanism of action of methimazole?

Answer 3

it decreases the production of hormone by inhibiting iodination of tyrosine

Question 4

what are the adverse effects of propylthiouracil?

Answer 4

skin rash, allergic reactions, agranulocytosis, and severe heptaotoxicity

Question 5

what is the purpose of radioactive iodine in thyroid treatment?

Answer 5

to ablate thyroid tissue in patients with Graves disease and toxic nodules

Question 6

what are common symptoms of hyperthyroidism?

Answer 6

elevated heart rate, hypertension, weight loss, and nervousness

Question 7

what is the average adult replacement dose of Levothyroxine?

Answer 7

1.6 mcg/kg/day

Question 8

how do you convert levothyroxine dosage to desiccate thyroid dosage?

Answer 8

multiply the levothyroxine dose by 0.65

Question 9

What is the primary cause of hypothyroidism in North America?

Answer 9

hashimoto’s thyroiditis

Question 10

what is a thyroid storm?

Answer 10

a life-threatening medical emergency caused by severe thyrotoxicosis

Question 11

What should be monitored after prescribing Levothyroxine?

Answer 11

TSH levels, typically adjusted every 6 weeks

Question 12

what are the adverse effects of levothyroxine if overdosed?

Answer 12

symptoms of hyperthyroidism, possible exacerbation of angina

Question 13

what is the role of Beta blockers like propranolol in thyroid disorders?

Answer 13

to ameliorate symptoms of adrenergic excess caused by excess thyroid hormone

Question 14

when is propylthiouracil preferred over methimazole?

Answer 14

during the first trimester of pregnancy

Question 15

what is the goal of therapy for thyroid disorders?

Answer 15

achieve a euthyroid state and manage symptoms

Question 16

what are the common causes of thyrotoxicosis?

Answer 16

graves disease, toxic nodules, iodine excess, and TSH-producing pituitary adenomas

Question 17

what is the typical initial dosing range for Levothyroxine in patients with mild symptoms?

Answer 17

25 to 50 mcg/day

Question 18

How long does it take to reach a new steady state after adjusting Levothyroxine dosage?

Answer 18

6 weeks

Question 19

what is the risk associated with thyroid surgery?

Answer 19

development of hypothyroidism

Question 20

What is the preferred medication for treating thyroid storm?

Answer 20

propylthiouracil

Question 21

what are the adverse effects of desiccated thyroid?

Answer 21

cardiovascular and neurological effects, including palpitations, tachycardia, and nervousness

Question 22

what factors can reduce the absorption of Levothyroxine?

Answer 22

antacids, mineral supplements, proton pump inhibitors, and estrogens

Question 23

what is the significance of TSH levels in thyroid treatment?

Answer 23

TSH levels guide dosage adjustments for Levothyroxine therapy

Question 24

what is the dosing calculation for a patient weighing 102 kg with a TSH of 21.3 U/mL?

Answer 24

use the equation: 107 + 0.69(TSH) -> 107 + 0.69(21.3) = 121 mcg

Question 25

what is the role of fine needle biopsy in thyroid disorders?

Answer 25

to diagnose thyroid nodules that require cytologic evaluation

Question 26

what are the contraindications for using methimazole?

Answer 26

it is contraindicated during the first trimester of pregnancy due to the risk of aplasia cutis

Question 27

what is the mechanism of action of propranolol in the context of hyperthyroidism?

Answer 27

it decreases the conversion of T4 to T3 and alleviates symptoms of adrenergic excess

Question 28

what should be done if a patient’s TSH remains unchanged after 6 weeks on Levothyroxine?

Answer 28

consider changing the time the patient take their iron supplement, as it may interfere with absorption