Thyroid disorders Flashcards
Hyperthyroidism: symptoms
high T3/T4, low TSH
- Weight loss
- Tachycardia
- Diarrhoea
- Anxiety
- Tremors
- Sweating
- Bulging eyes
- Enlarged thyroid gland - lump at front of neck
Hyperthyroidism: treatment
Carbimazole + propylthiouracil
MOA: interferes w synthesis of thyroid hormones: T3 + T4
Carbimazole + propylthiouracil: indication
Hyperthyroidism (first line: carbimazole)
- Regimen: titration OR block + replace
- Propylthiouracil: if pregnant or trying to conceive
Carbimazole + propylthiouracil: side effect
Blood dyscrasias
- Monitor: FBC
- Counsel: report signs of infection or blood disorders
Acute pancreatitis
- MHRA: STOP
Rashes + itching
- Antihistamines
- If intolerable: propylthiouracil
Carbimazole + propylthiouracil: pregnancy
Teratogenic - MHRA: congenital malformations: contraception
Propylthiouracil: side effect
Hepatotoxicity
- Monitor: LFT: discontinue if 3x ALT + AST
- Counsel: report signs of liver disorder
Hypothyroidism: symptoms
Low T3 + T4, high TSH
Caused by amiodarone + lithium
- Cold intolerance
- Weight gain
- Bradycardia
- Constipation
- Depression
- Muscle cramps
- Fatigue
- Loss of eyebrows
Hypothyroidism: treatment
levothyroxine + liothyronine
Levothyroxine + liothyronine: indication
Hypothyroidism
- First line: Levothyroxine
- Emergencies: liothyronine
Liothyronine
- 20-25mcg = 100mg levothyroxine
- Avoid switching brands without UK license
Levothyroxine
- In morning at least 30 min before breakfast, caffeine or other medication
- Interaction: 4 hr gap: antacids, calcium + iron
- MHRA: levothyroxine: new advice if symptoms when switching: If symptoms = TFT + prescribe tolerated brands, If symptoms or poor control = oral solution
Levothyroxine + liothyronine: side effect
Thyrotoxic symptoms
- Di, rapid pulse, insomnia, anxiety, tremors, anginal pain w latent ischaemia
- Caution: CVD, diabetes
