thyroid disorder

Question 1

what is T3

Answer 1

triiodothyronine

Question 2

what is T4

Answer 2

thyroxine

Question 3

levothyroxine IV to PO

Answer 3

0.75:1

Question 4

how are T3 formed

Answer 4

T4 is broken down to T3

Question 5

which is more potent T3 or T4

Answer 5

T3 but T4 has a shorter half life

Question 6

what drugs can cause Hypothyroidism

Answer 6

Interferons
tyrosine kinase inhibitor
amiodarone
lithium
carbamazepine

Hashimoto’s disease

Question 7

what is hypothyrodism

Answer 7

deficiency in T4 and elevation in TSH

Question 8

symptoms of hypothyroidism

Answer 8

fatigue, weight gain infertility CV disease

Question 9

what is myxedema and what is the treatment

Answer 9

potentially fatal complication of hypothyroidism
treatment is IV levothyroxine

Question 10

Diagnosis of hypothyroidism

Answer 10

low free T4- normal range 0.9-2.3
high TSH normal range 0.3-3
>60 years old

Question 11

how frequent is the TSH monitored

Answer 11

4-6 weeks

Question 12

drug of choice for hypothyroidism

Answer 12

levothyroxine (unithroid) or T4 is the drug of choice

Question 13

what medication is for T3 replacement

Answer 13

liothyronine

Question 14

what medication is T3 and T4

Answer 14

Armour thyroid

Question 15

levothyroxine T4 dose frequency

Answer 15

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

Question 16

tablet colors

Answer 16

Orange
white.
violet
olive
yellow
rose
brown
turqoise
blue
lilac
pink
green

o will vomit on you right before they become large proud giants

Question 17

what drugs decrease the effect of thyroid

Answer 17

antacids also polyvalent cations
SPS
veltessa (patiromer)
lanthanum
BB amiodarone propylthiouracil
fat soluble vitamin

Question 18

what drugs are affected by thyroid

Answer 18

warfarin
theophylline

Question 19

hyperthyroidism

Answer 19

T4 is high and TSH is low
increase in metabolsim
weight loss, insomnia
thinning hair

Question 20

what are some causes of hyperthyroidism

Answer 20

Graves disease - antibodies stimulate the production of T4

Question 21

drug tx of hyperthyroidism

Answer 21

PTU- propylthouracil
methimazole (tapazole)

Question 22

what is the MOA of thioamides

Answer 22

inhibits synthesis. of thyroid hormones by blocking oxidation of iodine in the thyroid gland (inhibits conversion of T3 from T4

Question 23

what are some AE of thioamides

Answer 23

hepatoxic
DILE

methimazole is drug of choice for lower heptoxic unless thyroid storm and if it not tolerated

Question 24

which thioamide is preffered in pregnancy

Answer 24

1st trimester PTU
2nd and 3rd is methimazole

Question 25

does iodine help in controlling hyperthyroidism

Answer 25

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

Question 26

thyroid storm symptoms

Answer 26

fever>103
tachycardia tachypnea
dehydration
sweating
agitation
delerium
psychosis.
coma

Question 27

tx for thyroid storm

Answer 27

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

Question 28

levothyroxine is safe during pregnancy

Answer 28

preffered

Question 29

levothyroxine drug interaction

Answer 29

antacids
sodium polystyrene
lanthanum
Estrogen
SSRI
hepatic inducer
BB
amiodarone
propylthiouracil