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NN- 7333 Pharm 2 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

Hypothyroidism:

Diagnosed lab testing

A
  • elevated TSH and decreased fT4
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2
Q

Hypothyroidism:

inflammatory

A

Hashimoto’s Thyroiditis

Can be inflammatory (Hashimoto’s Thyroiditis) or non-inflammatory

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3
Q

Hypothyroidism:

Treatment

A

Treatment is usually replacement of T4 and potentially replacement of T3

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4
Q

Hypothyroidism:

Pharmaceutical treatment

A

Pharmaceutical treatment is daily (1/2 life of T4 is 7 days; 80% absorbed)

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5
Q

Take care with dosing in the following patients:

A

Patients with CHD (need less)
Pregnant women (need more)
Women on HRT (need more)
Hashimoto’s patients (may need less or more)

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6
Q

Treatment Indication – Hypothyroidism #1

A

Levothyroxine (Levoxyl, Synthroid, Tirosint)

Dosing Adult: 25 – 200mcg po qd
Monitoring: TSH, fT4 every 4-8 weeks
Tip: Dosage should be titrated up every 4-6 weeks; administer on empty stomach 30 min away from food.
Main SE: arrhythmias, hypertension, tachycardia, anxiety, abdominal pain, GI upset, tremor

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7
Q

Hypothyroidism:
Avoid combination with the following drugs:
Levothyroxine

A

Sodium Iodide, Sucroferric Oxyhydroxide

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8
Q

Hypothyroidism:
Avoid combination with the following supplements:
Levothyroxine

A

ALA, Chromium, Iron

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9
Q

Treatment Indication – Hypothyroidism #2

A

Liothyronine (Cytomel, Triostat)

Dosing Adult: 5 – 50mcg po qd
Monitoring: TSH, fT3, total T3 every 4-8 weeks
Tip: Dosage should be titrated up every 4-6 weeks; administer on empty stomach 30 min away from food.
Main SE: arrhythmias, hypertension, tachycardia, anxiety, abdominal pain, GI upset, tremor

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10
Q

Hypothyroidism:
Avoid combination with the following drugs:
Liothyronine

A

Sodium Iodide, Sucroferric Oxyhydroxide

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11
Q

Hypothyroidism:
Avoid combination with the following supplements:
Liothyronine

A

Chromium, Iron

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12
Q

Treatment Indication – Hypothyroidism #3

A

Desiccated Thyroid (Armour, Nature-Throid)

Dosing Adult: ½ - 2 grain po qd (1 grain ~ 60-65mg)
1 grain = 38mcg T4 and 9mcg T3
Monitoring: TSH, fT4, fT3, Total T3 every 4-8 weeks
Tip: Dosage should be titrated up every 4-6 weeks; administer on empty stomach 30 min away from food.
Main SE: arrhythmias, hypertension, tachycardia, anxiety, abdominal pain, GI upset, tremor

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13
Q

Hypothyroidism:
Desiccated Thyroid
Avoid combination with the following drugs:

A

Sodium Iodide

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14
Q

Hypothyroidism:
Desiccated Thyroid
Avoid combination with the following supplements:

A

ALA, Chromium, Iron

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15
Q

Hyperthyroidism;

Diagnosed lab testing

A

decreased TSH and increased fT4, fT3 (total T3)

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16
Q

Hyperthyroidism;

INFLAMMATORY

A

Can be inflammatory (Graves’ Disease) or non-inflammatory

Lithium causes

17
Q

Hyperthyroidism;

Treatment depends on???

A

Treatment depends on cause of hyperthyroidism and can range from a watch and wait approach to thyroid suppression to thyroid ablation/surgery.

Pharmaceutical treatment is used to quickly control hyperthyroid symptoms

Constant monitoring of fT4, fT3 and TSH every 4-6 weeks post treatment is required until stabilization occurs.

18
Q

Hyperthyroidism;

Treatment Indication #1

A

Methimazole (Tapazole)–> first line treatment

Dosing Adult: 5 – 20mg po TID; or 5 – 10mg po qd (Graves)
Monitoring: TSH, fT4, fT3, CBC with diff, LFT
Tip: Can give a loading dose initially then lower maintenance dose.
Thioamide – blocks oxidation of iodine in the thyroid gland
Main SE: drowsiness, headache, weight gain, hepatic necrosis (Check liver every 3-6 mo), constipation, nausea, autoimmune reaction.

19
Q

Hyperthyroidism;
Methimazole
Avoid combination with the following drugs:

A

BCG, Clozapine, Dipryrone, Sodium iodide.

20
Q

Hyperthyroidism;
Methimazole
Alcohol?

A

Avoid combination with alcohol.

21
Q

Hyperthyroidism;

Methimazole Caution with?…

A

Caution with iodine supplementation.

22
Q

Hyperthyroidism;

Treatment Indication #2

A

Propylthiouracil (PTU)

Dosing Adult: 50 – 150mg po TID
Monitoring: TSH, fT4, fT3, CBC with diff, LFT
Tip: Can give a loading dose initially then lower maintenance dose.
Thioamide – blocks oxidation of iodine in the thyroid gland
Main SE: drowsiness, headache, weight gain, hepatotoxicity (More Toxic), constipation, nausea.

23
Q

Hyperthyroidism;
Propylthiouracil (PTU)
Avoid combination with the following drugs:

A

BCG, Clozapine, Dipryrone, Sodium iodide.

24
Q

Hyperthyroidism;

Propylthiouracil (PTU)

A

BCG, Clozapine, Dipryrone, Sodium iodide.

25
Q

Hyperthyroidism;
Propylthiouracil (PTU)

Alcohol??

A

Avoid combination with alcohol.

26
Q

Hyperthyroidism;

Propylthiouracil (PTU) Caution with?…

A

Caution with iodine supplementation.

27
Q

Hyperthyroidism med side effect

A

Weight Gain

NN- 7333 Pharm 2 (5 decks)

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