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Pharm Exam #3 > Thyroid Diseases > Flashcards

Thyroid Diseases Flashcards

1
Q

Methimazole initial tx dose for mild ____thyroidism

A

15 mg/day

Hyper

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2
Q

Methimazole initial tx dose for moderate ____thyroidism

A

30-40 mg/day

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3
Q

Methimazole initial tx dose for severe ____thyroidism

A

60 mg/day

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4
Q

Length of tx on Initial methimazole tx, end at _____

A

6-8 weeks

Euthyroid

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5
Q

Euthyroid

A

normal thyroid levels

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6
Q

Methimazole is preferred in what trimesters of pregnancy?

A

2nd and 3rd ONLY

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7
Q

Methimazole dose for breastfeeding

A

20-30 mg/day (1st line)

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8
Q

Methmazole maintenance dose for _____thyroidism

A

5-15 mg/day

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9
Q

PTU Propylthiouracil 1st line for

A

thyroid storm

1st trimester of pregnancy

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10
Q

MOA Methimazole

A
  • Inhibits thyroid hmone synthesis

- depletes stored hmone

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11
Q

MOA Propylthiouracil

A

-Inhibits peripheral T4 to T3 conversion within hours

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12
Q

Thioamide Monitoring: Reassess pt every

A

4 weeks

until Euthyroid

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13
Q

Remission is

A

Euthyroid for 12 mo

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14
Q

Thioamide Monitoring: low dose every 2-3 mo check

A

T4, TSH and s/sx

keep tapering

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15
Q

Thioamide adverse effects

A

GI upset
Arthralgia
Rash, uticarua, pruritis

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16
Q

Thioamide severe adverse effect

A

Agranulocytosis
(granulocyte count <250, give em ABX!!)
Hepatotoxicity
(higher risk PTU)

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17
Q

How soon should TSH be tested after a pt achieves remission?

A

2-3 mo

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18
Q

Iodine MOA

A

bombard the body with iodine so it inhibits hmone release and dec. hmone syntheses

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19
Q

Iodine tx lasts for

A

D/C after 1-2 weeks! short tx

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20
Q

Iodism s/s (adverse effect!)

A

(iodine OD) burn in mouth, metallic taste, sore teeth/gums, cold s/s

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21
Q

Iodine Adverse effects (other)

A

rash, GI upset, salivary gland swelling, immune hypersensitivity rxn, paresthesia

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22
Q

Iodine initial dose to tx _____thyroidism

A

120-400mg orally in H20 or juice

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23
Q

Lithium dose to tx _____thyroidism

A

300 mg Q8hrs

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24
Q

Lithium MOA

A

block T3/T4 release

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25
Q

Lithium: Monitor

A

serum level < 1 mEq/L

26
Q

Beta Blockers MOA to tx ____thyroidism

A

Hyper

block B adrenergic receptors

27
Q

B Blocker- Esmolol use in ___ via ___ dose____

A

ICU- thyroid storm
IV
50-100 mcg/kg/min

28
Q

Propanolol dose

A

10-40 mg PO 3-4x/day

may dec T4 to t3 conversion

29
Q

Nadolol dose

A

40-60 mg PO 1 x day
may dev T4 to T3 conversion
don’t use in pt with COPD

30
Q

Atenolol dose

A

25-100 mg PO 1-2 x day

31
Q

Metoprolol dose

A

25-50 mg PO 4x day

32
Q

Preferred tx in Thyroid Storm

A

high dose PTU

33
Q

Radioactive Iodine is a tx cure for ____

goal:

A

Hyperthyroidism

goal: induce hypothyroidism

34
Q

Radioactive Iodine MOA:

A

taken into thyroid by TSH-R Ab
incorporated into thyroid hmone and stored in colloid
emit B particle to irreversibly damage thyrocytes

35
Q

RAI Contrindications

A

Pregnancy (hold 6-12 mo)
Lactation
Thyroid Cancer

36
Q

RAI Monitor

A

T3/T4 2-4 weeks post tx

37
Q

RAI adverse effects

A

dysphagia, thyroid tenderness

38
Q

Pt in Thyroid Storm, what meds to initiate?

A
  1. PTU
  2. B Blocker (propranolol)
  3. cool blankets
  4. Tylenol
  5. Hydrocortisone
39
Q

1st Line Med for hypothyroidism

A

Levothyroxine!

40
Q

Initiate Treatment when TSH >

and pregnancy

A

TSH > 10 mlU/L

TSH 2.5-4.5 mlU/L (pregnancy)

41
Q

Levothyroxine full replacement dose

A

1.6 mcg/kg/day

multiply x kg body weight

42
Q

IV Levothyroxine

A

75% of oral dose

43
Q

Monitor Levothyroxine @normal level

A

TSH and FT4 1x ever 6-12 mo

44
Q

Levothyroxine is a _____

A

synthetic thyroid supplement, mimics T4

45
Q

Liothyronine dose

A

relative dose = 15-37.5 mcg

46
Q

Liothyronine acts as

A

Synthetic T3

47
Q

Liotrix dose

A

50-60mcg T4 and 12.5-15mcg T3 in 1 tablet

48
Q

Liotrix is a ratio of

A

T4:T3
4:1

49
Q

ADE Synthetics

A

uncommon at appropriate doses

if overt treat then hyperthyroid s/sx

50
Q

Natural Thyroid Hmone from

A

hog, beef and sheep

51
Q

Contraindications Natural Hmone

A

Religious beliefs- no pork

DIs

52
Q

Natural Hmone Dose

A

1 grain= about 60mg T4 but variable

53
Q

PTU initial dose

A

100-150mg every 6-8 hrs

54
Q

PTU maintenance

A

50-150mg/day

55
Q

Lithium Adverse Rxn

A

Tremor, polyuria, renal failure, seizure, arythemia, bradycardia, suicide, toxicity

56
Q

Decrease Absorption Levothyroxine

A 
Aluminum hydroxidie
Cholestyramine
Calcium Carbonate
Dietary Fiber
Ferrous Sulfate
FOOD
Soybean formula
Sucralfate
57
Q

Amiodarone

A

inc or dec thyroid levels

monitor TSH and FT4 every 6mo + baseline

58
Q

Digoxin

A

inc digoxin levels

dec dose thyroid meds

59
Q

Warfarin

A

inc or dec anticoagulation

monitor INR

60
Q

hyperthyroid + warfarin

A

more likely for pt to bleed bc inc metab of clotting factors

61
Q

insulin

A

inc risk hyperglycemia

inc insulin, pt monitor blood glucose

Pharm Exam #3 (1 decks)

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