Thyroid Flashcards
1
Q
Management goals in hyperthyroidism
A
Achieve euthyroidism by
- Antithyroid drugs (thionamides)
- Radioactive iodine
- (Partial) thyroidectomy
2
Q
Thionamies, MOA, SEs
A
CARBIMAZOLE
- Decrease production of thyroid hormones by inhibiting iodination of thyroglobulin via inhibtion of thyroperoxidase
- THs have longs half life, so effect take week
- May cause agranulocytosis leading to leucopenia
- Be aware of sore thorats, mouth ulcers, bruising or non-specific illness
3
Q
Beta-blockers MOA in hyperthyroid
A
- Reduce action of catecholamines at beta-receptors
- Symptomaitc relief of tremor, anxiety, palpitations
- Give diliazem to control tachycardia if BBs CI
- Non-selective BBs e.g. propanolol are required to relieve tremor
4
Q
Hyperthyroid management steps
A
5
Q
Hypothyroid treatment
A
- Levothyroxine
- YOUNG: 50-100mg, may be increased after six weeks until maintenance achieved I.E. Correct TSH levels
- ELDERLY/IHD: start w/ 25mg, increased by same increment every 3-4 weeks
- Thyroxine may worsen angina
- Lifelong