Thyroid Disorders Flashcards
An autoimmune disease resulting from cell and antibody mediated thyroid injury.
Hashimoto disease
Hyposecretion of the thyroid hormone causes what?
Myxedema, goiter and cretinism
Signs and symptoms of Hypothyroidism.
Sensitivity to cold, constipation, brady and weight gain.
Signs: dry flaky skin, coarse hair, slurred speech, puffyface, hands, feet and hearing loss. Dec libido, slow return of deep tendon reflexes
Diagnostic tests and results for Hypothyroidism.
Initial test is serum TSH assay and TSH levels are elevated in primary hypothyroidism and low serum free T4
Inc. serum TSH, dec. FT4 and TT4
Thyroid hormones increase what drug effect and how?
Warfarin effect. Increases catabolism of vitamin K dependent clotting factors= inc. warfarin effect.
What declines with initiation of levothyroxine?
Glycemic control. Antihyperglycemic agents may be required.
These drugs reduces absorption due to binding to levothyroxine.
Antiepileptics
cholestyramine, colestipol (separate 6)
Iron salts Ca, Mg and sucralfate (2h)
do not take Al
Levothyroxine dosing.
T4: 1.6mcg/kg/day
12.5-25mcg/day pts w Coronary Artery Disease or elderly
Pregnancy: Increase dose
Common form of hyperthyroidism, antibodies produced against autoantigens stimulates secretion of thyroid hormone.
Grave’s disease.
Complete opposite of Hashimoto= inhibits secretion of thyroid hormone
Hyperthyroidism may cause what and give symptoms.
Intolerance to heat, weight loss, weakness and anxiety.
Signs: heart palpitation, nervousness, diarrhea and tachycardia
Hyperthyroidism diagnosis
Decreased TSH (sensitive) Increased T4 and T3
What is the essential functional group for antithyroid activity?
Thiocarbamide (R-C=S)-NH-R)
Explain antithyroid drug mechanism of action Deiodination.
Inh. iodination of Tyrosine in thyroglobulins and thyroid peroxidase thus inh.T4 to T3.
Deiodination is activation of thyroxine T the degradation of thyroid horm. eliminated by feces and urine. T4 to actv triiodothyronine T3 in peri. and liver tissues.
Oral drops of Iodide, will stain.
Decreases gland size and blood supply therefore used for surgery preparation.
Inhibits uptake of I2 by what amino acid?
Lugol’s solution (KI + I)
10% KI and 5% I
Inhibits uptake of I2 by Tyrosine.
DOC for hyperthyroidism for pregnanct and lactating women.
Propylthiouracil
does not cross BBB