Thyroid Flashcards
what med do you use if the problem is conversion of T4 to T3?
cytomel
if no response to synthroid (T4) problem is likely what?
conversion problem from T4 to T3
titrate synthroid every by checking
6-8 weeks TSH
If pt has Addisons dz, want to do what?
start on cortisol before initiating thyroid support
60mg of Thyroid USP/Armour = what in synthroid?
100mcg of synthroid/t4 and 25 mcg of T3/cytomel
exopthalmos
sclera above and below iris
what are concomitants of Grave’s dz?
exopthalmos
osteoporoiss
heart disease
pretibial myxedema: non-pitting edema glycoaminoglycans/hyluronic acid builds up in skin
therapy for hyperthyroid
thionamides: chance of permanent remission, rash, etc
radioiodine: permanent resolution, but oncogenic effects
surgery: permanent, laryngeal nerve damage
methimazole/tapazole
thioamide, temporary tx
IV for thyroid storm
blocks thyroid peroxidase so can’t make T4
allow for better control until definitive therapy can be administered
SE: rash, edema, arthralgias, agranulocytosis
not given beyond 6-12 months
propylthiouracil (PTU)
thioamide
IV for thyroid storm PO for hyperthyroid
inhibits transformation of inorganic iodine to organic iodine so inhibits T3 and T4 formation
*also blocks peripheral conversion of T4 to T3
SE: rash, edema, arthralgias, agranulocytosis
not given beyond 6-12 months
Which thioamide is better at blocking peripheral conversion of T4 to T3?
- also used before surgery or radioactive
Propylthiouracil (PTU)
propranolol
beta blocker
blocks symptoms of hyperthyroid
Iodine
large doses of iodine inhibit release of thyroxine form thyroid gland
rash, fever, don’e use longer than 2-3 weeks
Radioactive iodine
definitive tx
gone within 3-5 days from system
concentrates in thyroid gland
