Thyroid Flashcards
Euthyroid
normal thyroid gland function
Goiter
Visible enlargement of the thyroid gland
Graves Disease
antibody mediated autoimmune disease resulting in hyperthyroidism
Hashimoto’s Thyroiditis:
Autoimmune disease often resulting in hypothyroidism
Thyroid Stimulating Hormone (TSH)
Secretion of T3, T4
via a negative feedback mechanism
Level of thyroid hormone in then lose determines release of TSH
Normal Thyroid levels
TSH (0.4 to 4.5)
If less than 0.4 = hyperthyroid/overactive
If above 4.5 – hypothyroid
T4 (4-11)
T3 (80-180)
Symptoms of Hypothyroidism
Fatigue
Depression
Dry Skin
Constipation
Bradycardia
Altered menstrual cycles
Weight gain
Changes in hair
Cold intolerance
Hypothyroidism
Decrease in hormone production
Can be a primary problem, can be autoimmune (Hashimoto’s, Thyroiditis)
Myxedema
severe hypothyroidism
Levothyroxine
Hypothyroid medication
Synthetic form of T4
Half-life of 6-7 day
(4-7 weeks to feel better)
Should be taken on an empty stomach 30 minutes before breakfast
Highly protein bound (high drug interactions)
Side effects are usually similar to hyperthyroidism if dose too high
Hypothyroid Medication
Levothyroxine
Armour Thyroid (desiccated)
Hyperthyroid Medication
Methimazole
Propylthiouracil (PTU)
Iodine Solutions
Desiccated Thyroid
AKA: Amour Thyroid (NOT given regularly)
Is a thyroid extract that comes from animal thyroid glands that have been dried and powdered
Contains both T3 and T4
Variable bioavailability
Side effects: Change in appetite, chest pain, diarrhea
Hyperthyroidism
Increased in circulating T3 and T4 which comes from overactive thyroid or excessive thyroid hormone production
Can be mild or if not treated can lead to death
Graves Disease, an autoimmune disease is caused by hyper functioning of the gland
Thioamides
Lower levels by inhibiting formation of thyroid hormones in the cells
Inhibit conversion of T4 to T3
Prior to starting, must obtain baseline CBC and liver profile
Medications should be taken on an empty stomach 30 minutes before eating
Can take several weeks to see effect
Symptoms of Hyperthyroidism
Anxiety
Restlessness
Diaphoresis
Diarrhea, N/V
Tachycardia (check for A fib)
Weight loss
Heat intolerance (hot all the time)
Exophthalmos- Bulging Eyes
Changes in menstrual cycle
Insomnia
Thyroid function
Metabolic activity
Produce me heat
Stimulates carbs, fat and protein
Increase erythropoiesis
Increase glucose absorption
Mood
Growth hormone
Insulin and Sex steroids
Nurse considerations
Avoid given calcium (antacid, iron supplements)
Assess heart rate
Life long medication
Have TSH checked 6-8 weeks
Safe if pregnant
Methimazole
Hyperthyroid medicine
Give once a day
Side effects: less GI side effects, can cause bone marrow suppression.
Do not give to pregnant patients
Propylthiouracil (PTU)
Converts T4 to T3..given to Graves’ disease
First trimester of pregnancy
Black box-liver
Iodine
Lugols solution- short term, non radioactive
Inhibits release of T3 and T4
Can cause iodinism (metallic taste, stomatitis, sore throat
Avoid seafood
I-131 (iodine)
Radioactive, used for thyroid cancer
Increase fluid intake (flushes iodine out of body)
Not given when pregnant
Adjuvant therapy
Beta blockers
Propranolol and atenolol (control symptoms of hyperthyroidism) while waiting for meds to take effect
