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Pharma 5 > Thyroid and Antithyroid > Flashcards

Thyroid and Antithyroid Flashcards

1
Q

T4 Half life

A

5-7 days

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2
Q

T3 half life

A

1 day

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3
Q

Case: Px presents with weight loss, tremors, hyperdefecation and exopthalmos. Dx?

A

Grave’s Dse (Hyperthyroidism)

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4
Q

Case: Px presents with weight loss, tremors, hyperdefecation and exopthalmos. tx?

A

Propylthiouracil
Levothyroxine
Methimazole

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5
Q

Inhibits conversion of T4 to T3

A

Propylthiouracil

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6
Q

Inhibits iodide concentration (Trapping)

A

Pertechnetate

Perchlorate

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7
Q

Inhibits Iodination/ Organification

A

Thioamides, Iodide

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8
Q

Inhibits Coupling

A

Thioamides, Methimazole

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9
Q

Inhibits Hormone release

A

Li salts, Iodides

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10
Q

Inhibits deiodination

A

PTU

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11
Q

Inhibits peripheral action (conversion of T4 -> T3)

A 
Beta blocker
Corticosteroids
Ipodate
PTU
Amiodarone
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12
Q

PTU
Methimazole
Carbimazole

A

Thioamides

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13
Q

Thioamides MOA

A

Irreversible binding of THYROID PEROXIDASE thus inhibiting it

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14
Q

PTU:Methimazole dosage

A

3 times a day (shorter duration): once a day

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15
Q

Which crosses the placenta?

a. Methimazole
b. PTU
c. Both

A

C

PTU crosses less readily

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16
Q

Thioamides ADR

A

Most common: RASH

Rare and dangerous: AGRANULOCYTOSIS

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17
Q

DOC for thyrotoxicosis

A

Methimazole

*PTU is hepatotoxic

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18
Q

Most common consequence of maternal hypothyroidism treated with Methimazole

A

Choanal Atresia- nasal septum malformation

Pwede ring aplasia cutis

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19
Q

Recommended for pregnant patients

A

PTU in the first trimester, Methimazole after

Why switch? PTU is Hepatotoxic!

20
Q

Useful in preparation in surgery, THYROID STORM

A

Iodide

21
Q

2 Phenomenons which Iodide can induce

A

Jod-Basedow (Hyper), Wolff-Chaikoff (Hypo)

22
Q

Acute onset of Iodide effects

A

2-7 days

23
Q

When is Lugol’s solution and Potassium iodide given?

A

AFTER admin of antithyroids

*Not before, can induce hyperthyroidism

24
Q

Fetal goiter in chronic iodide use

A

Iodide can readily cross the placenta and can be excreted in the breastmilk

*Normal excretion- urine

25
Q

Iodide ADR

A

Metallic taste
rash
Fetal goiter

26
Q

1st isotope used for treatment of thyrotoxicosis

A

Radioactive Iodine (Oral)

27
Q

Maximum effects of RI can be felt within

A

3-6 months

28
Q

Advantages of RI

A

Easy admin
Less costly
Absence of pain

29
Q

Consequence of maternal use of RI during admin or 6-12 mos after

A

Destruction of Fetal thyroid gland

30
Q

RI ADR

A

Sialitis (mag dictionary ka tang ina mo)

31
Q

RI admin of 100-200mg

A

Thyroid Cancer

32
Q

RI admin of 500 mg

A

Leukemia

33
Q

they don’t really lower thyroid levels

A

Beta Blockers

34
Q

Beta Blockers

A

antagonize the target organ effects of thyroid hormone

35
Q

Beta Blockers effect on Hyperthyroid patients

A

Lowering heart rate especially for those who have palpitations
Reducing tremors

36
Q

Propanolol is the same with PTU in?

A

Inhibiting conversion of T4-T3

37
Q

Main Indication of Propanolol

A

Thyroid Storm

38
Q

Difference of propanolol to other B Blockers

A

Shorter duration (4-6 hrs), must be given 3 times a day (oral)

39
Q

Case: 55 y/o female with cold intolerance, weight gain, easy fatigability, edema and diffuse goiter. Dx?

A

Hypothyroidism

40
Q

Case: 55 y/o female with cold intolerance, weight gain, easy fatigability, edema and diffuse goiter. Tx?

A

Levothyroxine

41
Q

Levothyroxine>Liothyronine

A

Levo (L-T4) is IV, Fair to Good absorption, longer duration (Half life- 7days) and more likely to bind to protein

Liothyronine is not commercially available

42
Q

Levothyroxine MOA

A

Suppression of TSH

43
Q

Drug that can increase serum levels of T4

A

Estrogen- increases TBG

*Acute infectious hepatitis

44
Q

Drugs that decrease TBG

A

Androgens, Glucocorticoids

*Nephrotic Syndrome

45
Q

Drugs affecting Thyroid Hormone Binding

A

Phenytoin
Diazepam
Salicylates

46
Q

Drugs that interfere absorption of L-T4

A

Cholestyramine
Al Hydroxide
Fe Sulfate
Ca

47
Q

Thyroid hormone dose requirements _____ during pregnancy

a. Inc
b. Dec
c. Stay the same

A

A

Pharma 5 (3 decks)

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