thyroid disorder Flashcards
what is T3
triiodothyronine
what is T4
thyroxine
levothyroxine IV to PO
0.75:1
how are T3 formed
T4 is broken down to T3
which is more potent T3 or T4
T3 but T4 has a shorter half life
what drugs can cause Hypothyroidism
Interferons
tyrosine kinase inhibitor
amiodarone
lithium
carbamazepine
Hashimoto’s disease
what is hypothyrodism
deficiency in T4 and elevation in TSH
symptoms of hypothyroidism
fatigue, weight gain infertility CV disease
what is myxedema and what is the treatment
potentially fatal complication of hypothyroidism
treatment is IV levothyroxine
Diagnosis of hypothyroidism
low free T4- normal range 0.9-2.3
high TSH normal range 0.3-3
>60 years old
how frequent is the TSH monitored
4-6 weeks
drug of choice for hypothyroidism
levothyroxine (unithroid) or T4 is the drug of choice
what medication is for T3 replacement
liothyronine
what medication is T3 and T4
Armour thyroid
levothyroxine T4 dose frequency
use IBW
full replacement dose 1.6mcg/kg/day
if known CAD start with 12.5-25mcg daily
taken with water atleast 60 mins before breakfast or at bedtime
IV to PO ratio 0.75:1
tablet colors
Orange
white.
violet
olive
yellow
rose
brown
turqoise
blue
lilac
pink
green
o will vomit on you right before they become large proud giants
what drugs decrease the effect of thyroid
antacids also polyvalent cations
SPS
veltessa (patiromer)
lanthanum
BB amiodarone propylthiouracil
fat soluble vitamin
what drugs are affected by thyroid
warfarin
theophylline
hyperthyroidism
T4 is high and TSH is low
increase in metabolsim
weight loss, insomnia
thinning hair
what are some causes of hyperthyroidism
Graves disease - antibodies stimulate the production of T4
drug tx of hyperthyroidism
PTU- propylthouracil
methimazole (tapazole)
what is the MOA of thioamides
inhibits synthesis. of thyroid hormones by blocking oxidation of iodine in the thyroid gland (inhibits conversion of T3 from T4
what are some AE of thioamides
hepatoxic
DILE
methimazole is drug of choice for lower heptoxic unless thyroid storm and if it not tolerated
which thioamide is preffered in pregnancy
1st trimester PTU
2nd and 3rd is methimazole
does iodine help in controlling hyperthyroidism
YES temporarily inhibits secretion of thyroid hormone
Lugols solution is an iodine solution
also used after exposure to radiation to block the accumulation of radioactive iodine
thyroid storm symptoms
fever>103
tachycardia tachypnea
dehydration
sweating
agitation
delerium
psychosis.
coma
tx for thyroid storm
PTU 500-1000mg loading dose then 250mg q4 hours +
inorganic iodide therapy SSKI 5 drops or lugols +
BB = propranolol +
steroid = dexamethasone 2-4 mg +
aggressive cooling with acetaminophen and cooling blankets
levothyroxine is safe during pregnancy
preffered
levothyroxine drug interaction
antacids
sodium polystyrene
lanthanum
Estrogen
SSRI
hepatic inducer
BB
amiodarone
propylthiouracil
