Thyroid Flashcards
1
Q
Triiodothyronine
A
T3 (3 iodine atoms)
-More potent than T4, but shorter half life
2
Q
Thyroxine
A
T4 (4 iodine atoms)
-Broken down into T3
3
Q
Drugs that Cause HYPOthyroidism
A
ITALC
- Interferons**
- Tyrosine Kinase Inhibitors
- Amiodarone**
- Lithium
- Carbamazepine
Conditions: Hashimoto’s Disease
4
Q
S/Sxs of HYPOthyroidism
A
- Cold intolerance/sensitivity
- Dry skin
- Fatigue
- Muscle cramps/myalgias/weakness
- Weight gain
- Goiter
- Bradycardia
- Constipation
- Menorrhagia (heavier periods)
5
Q
Levoxyl
A
- Levothyroxine (T4) - AKA Synthroid and Unithroid
- Drug of choice for hypothyroidism (constant preparation)
- Full replacement dose = 1.6 mcg/kg/d (IBW)
- If known CAD, start at 12.5-25 mcg/d
- IV:PO is 0.75:1
- Monitor TSH levels/clinical sxs Q4-6w until normalized
- Safe in pregnancy but may need to increase maintenance dose by 30-50% throughout preggo course
6
Q
Armour Thyroid
A
-Thyroid, desiccated (T3 and T4)
7
Q
Cytomel
A
- Liothyronine (T3)
- Shorter half life!
8
Q
Levothyroxine Tablet Colors
A
Orangutans Will Vomit On You Right Before They Become Large, Proud Giants Orange = 25 mcg White (no dye) = 50 mcg Violet = 75 mcg Olive = 88 mcg Yellow = 100 mcg Rose = 112 mcg Brown = 125 mcg Turquoise = 137 mcg Blue = 150 mcg Lilac = 175 mcg Pink = 200 mcg Green = 300 mcg
9
Q
Drugs that cause HYPERthyroidism
A
- Iodine (radiocontrast dye)
- Amiodarone**
- Interferons**
Condition: Grave’s Disease
10
Q
S/Sxs of HYPERthyroidism
A
- Heat intolerance/increased sweating
- Weight loss
- Agitation/anxiety
- Palpitations/tachycardia
- Insomnia
- Tremor
- Fatigue/muscle weakness
- Frequent bowel movements/diarrhea
- Light/absent menstruation
- Protruding eyeballs (exophthalmos)
B-blockers can help control sxs
11
Q
PTU
A
- Propylthiouracil
- Thionamide: inhibits synthesis of thyroid hormones and stops peripheral conversion of T4 to T3
- Box warning: severe liver injury and acute failure
- Preferred agent for 1st trimester
- Preferred for thyroid storms
12
Q
Tapazole
A
- Methimazole
- Thionamide: inhibits synthesis of thyroid hormones and stops peripheral conversion of T4 to T3
- Drug of choice in 2nd and 3rd trimesters
- Generally speaking the drug of choice over PTU except in situations mentioned on card
13
Q
Thionamide Information
A
- Warning: hepatotoxic, DILE drugs, agranulocytosis (rare)
- SE: GI upset
14
Q
S/Sxs of Thyroid Storm
A
- Fever (>103 F)
- Tachycardia/tachypnea
- Dehydration
- Profuse sweating
- Agitation
- Delirium/psychosis
- Coma
15
Q
Thyroid Storm Tx
A
- Antithyroid therapy - PTU preferred
- Inorganic iodine therapy - SSKI or Lugol’s solution
- B-blocker - propranolol preferred
- Systemic Steroid - dexamethasone
- Aggressive cooling- APAP and cooling blankets
