Thyroid Disorders Flashcards
What is the most commonly used antithyroid drug?
Carbimazole.
When should propylthiouracil be used in as an antithyroid drug?
When patients are intolerant of carbimazole or for those who experience sensitivity reactions to carbimazole.
When is radioactive iodine contraindicated for overactive thyroid?
In pregnancy.
How do carbimazole and propylthiouracil work in the treatment of an overactive thyroid?
By interfering with the synthesis of thyroid hormones.
Neutropenia and agranulocytosis are both risks associated with the use of carbimazole. What signs and symptoms should the patient be aware of?
Signs and symptoms suggestive of infection, especially sore throat.
If there is any clinical evidence of infection when a patient is on carbimazole, what monitoring is required?
A white cell count.
If there is any clinical or laboratory evidence of neutropenia whilst a patient is on carbimazole, what course of action should be taken?
Carbimazole should be stopped promptly.
When initially dosing levothyroxine and liothyronine, what monitoring is valuable and why?
Baseline ECG as changes induced by hypothyroidism can be confused with ischaemia.
If diarrhoea, nervousness, rapid pulse, insomnia, tremors, and sometimes anginal pain occur upon initial dosing with levothyroxine or liothyronine, what course of action should be taken?
Reduce dose or withhold for 1-2 days and start again at a lower dose.
Why should patients who are switched between different brands of liothyronine be monitored?
Because different brands may not be bioequivalent and dose adjustment may be necessary. Thyroid status may need reviewing.
After any change in liothyronine brand, when should monitoring of TFTs be carried out?
1-2 months after any change in brand.
