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NAPLEX > thyroid > Flashcards

thyroid Flashcards

1
Q

triiodothyronine

A

t3

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2
Q

thyroxine

A

t4

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3
Q

what is more potent t3 or t4

A

t3

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4
Q

what is active t3 or t4

A

t4, which is what is monitored and watched in patients

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5
Q

drugs and conditions that can cause hypothyroidism

A 
I TALC
I interferons
T tyrosine Kinase Inhbitors 
A Amiodarone
L Lithium
C Carbamazepine

+Hasimotos+

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6
Q

drugs that can cause hyper or hypothyroid

A

Interferons and Amiodarone

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7
Q

hypothyroid is

A

decrease in t4 and increase in tsh

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8
Q

symptoms of hypo

A 
cold intolerance
dry skin
fatigue
muscle cramps
voice changes
constipation
weight gain
goiter
myalgias
weakness
depression
bradycardia
caorse hair/loss of hair
menorrhagia (heavier than normal menstrual periods)
memory and mental impairment
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9
Q

primary test for function of thyroid

A

tsh

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10
Q

monitor tsh levels every

A

4-6 weeks until levels are normal

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11
Q

too high thyroid replacement dose in elderly can cause

A

afib and fractures

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12
Q

DOC for hypothyroidism

A

levothyroxine (Synthroid)

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13
Q

other meds for hypothyroid

A 
desiccated thyroid (armour thyroid)
liothyronine (cytomel)
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14
Q

cytomel

has

A

liothyronine

t3

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15
Q

dessicated thyroid has

A

t3 and t4

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16
Q

levothyroxine has only

A

t4

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17
Q

levothyroxine full replacement dose

A

1.6 mcg/kg/day use IBW

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18
Q

what weight to use for levothyroxine

A

IBW!

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19
Q

if patient less than 50 use

A

1.6 mcg/kg/day IBW

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20
Q

initial starting dose CAD of levothyroxine

A

12.5 mcg- 25 mcg

21
Q

Iv to po levothyroxine

A

0.75:1

22
Q

levothyroxine is highly protein bound yes or no

A

yes

23
Q

how to take levothyroxine

A

full glass of water
at the same time each day for consistent absorption
60 min before breakfast!
or at bedtime at least 3 hours after the last meal

24
Q

levothyroxine tablet colors

A 
orangutans - orange (25)
will -  white (50) no dye
vomit - violet (75)
on - olive (88)
you - yellow (100) 
right - rose (112)
before- brown (125)
they- turquoise (137)
become- blue (150) 
large- lilac (175)
proud - pink (200)
giants- green (300)
25
Q

if you become pregnant and on levothyroxine you will likely need to

A

increase dose

26
Q

drugs that decrease levothyroxine absorption

A 
antacids
iron
calcium
aluminum
magnesium
multivitamins
cholestyramine
orlistat(alli,xenical)
sevelamer, sucralafate

seperate doses by 4 hours

27
Q

estrogen and ssris decrease

A

levothyroxine

28
Q

beta blockers amiodarone ptu and systemic steroids decrease

A

levothyroxine effectiveness

29
Q

warfain and levothyroxine

A

increases effect of warfarin

increase in PT and INR

30
Q

levothyroxine and theophylline

A

decrease in theophylline

31
Q

levothyroxine causes an effect on two major drugs

A

warfarin (increase)

theophylline (decrease)

32
Q

levothyroxine how soon before breakfast

A

an hour

33
Q

hyperthyroidism symptoms

A 
heat intolerance or increased sweating
weight loss
agitation
nervousness
irritability
anxiety
tachycardia,palpitations
fatigue 
muscle weakness
insomia
tremor
thinning hair
goiter
exophthalmous (protrusion of the eyeballs)
diplopia
light or absent menstrual periods
34
Q

autoimmune condition for hyperthyroid

A

graves disease

antibodies

35
Q

drugs that can cause hypo

A

amiodarone
iodine
interferons

36
Q

what can you use for hyperthyroid symptoms

A

propanolol any beta blockers

37
Q

propylthiouracil and methimazole have a boxed warning for

A

severe liver injury and acute liver failure

PTU preferred in first trimester

38
Q

warnings with ptu and methimazole

A

hepatotoxicity
agranulocytosis
DILE

39
Q

SE with PTU and Methimazole

A

GI upset

40
Q

how to take PTU/methimazole

A

with food to decrease risk of gi upset

41
Q

which is the DOC ptu or methimazole

A

methimazole

unless thyroid storm or 1st trimester preg.

42
Q

if pregnant use PTU in first trimester than switch to

A

methimazole in 2nd and 3rd trimesters to reduce risk of liver toxicity

43
Q

what to use after exposure to radiation

A

potassium iodide (KI) it prevents thyroid cancer

44
Q

signs and sym of thyroid storm

A 
fever greater than 103
tachycardia 
tachypnea
dehydration
profuse sweating
agitation
delirium
psychosis
coma
45
Q

how to treat thyroid storm

A 
PTU
SSKI or Lugol soln
Beta blocker (propanolol)
Steroid (dexamethasone)
Cooling (blankets and tylenol)
46
Q

levothyroxine once pregnant

A

increase dose by 30 to 50 percent

47
Q

liotrix has

A

t4 and t3 in a 4:1 ratio

48
Q

greater than 60 starting dose

A

25 to 50 mcg QD

49
Q

levothyroxiNe

A

normal saline and use immediately

NAPLEX (24 decks)

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