Thyroid Disorders Flashcards
What are the symptoms of hyperthyroidism?
Heat intolerance Weight loss Diarrhoea Tachycardia Excitability Tremors Angina Sweating Arrhythmias
What do thyroid hormones regulate?
Metabolic rate Heart rate Digestive function Muscle control Brain development
What are the lab test results that suggest hyperthyroidism?
High T4 and T3
Low TSH
What is the mechanism of action of carbimazole/propylthiouracil?
Anti thyroid drugs interfere with synthesis of thyroid hormones
What are the side effects of carbimazole?
Bone marrow suppression - agranulocytosis and neutropenia
Rashes/itching
What are the counselling points for carbimazole?
Report signs of infection - fever, malaise, mouth ulcers, sore throat
What are the side effects of propylthiouracil?
Hepatotoxicity
What are the counselling points for propylthiouracil?
Stop and report signs of liver failure
What are the symptoms of thyrotoxicosis?
Increased heart rate Tachycardia Heat intolerance Diarrhoea Dehydration Seizures
What drugs cause thyrotoxicosis?
Anti thyroid drugs
Fluids
Hydrocortisone
Radioactive sodium iodide solution
What is used for symptomatic relief of thyrotoxicosis?
Propranolol
What drug needs to be given before a partial thyroidectomy?
Iodine 10-14 days before
What medications are used for hyperthyroidism in pregnancy?
1st trimester - propylthiouracil
2nd trimester - carbimazole
What are the symptoms of hypothyroidism?
Cold intolerance Weight gain Constipation Bradycardia Lethargy Muscle cramps Slow movements Slow thoughts Depression Hair thinning
What are the lab test results for hypothyroidism?
Low T3 and T4
High TSH
What is the mechanism of action of levothyroxine and liothyronine?
Synthetic thyroid hormones as replacement therapy
What is the dose for levothyroxine?
Question anything above 200mcg
How do you take levothyroxine?
In the morning at least30 minutes before breakfast, caffeine containing liquids or other medication
When is liothyronine used?
It has a more rapid effect and is more potent
Used in severe hypothyroid emergencies
Care when switching brands
What happens if the metabolism increases too quickly after being started on levothyroxine?
Cause hyperthyroidism symptoms
Reduce dose or withhold 1-2 days and start again at a lower dose