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Year 2 > Thyroid Drugs > Flashcards

Thyroid Drugs Flashcards

1
Q

What is Levothyroxine (T4) used to treat?

A

Hypothyroidism

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2
Q

Why is Levothyroxine (T4) the agent of choice for thyroid replacement and suppression therapy?

A

It is stable, low cost, lacks allergenic protein, and has LONG HALF LIFE permitting once daily administration.

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3
Q

What is Liothyronine (T3) used to treat?

A

Hypothyroidism

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4
Q

Which more potent, Levothyroxine or Liothyronine?

A

Liothyronine is 3-4 times more potent.

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5
Q

Does Liothyronine have a long or short half life?

A

Short half life, requiring multiple doses.

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6
Q

Is Liothyronine recommended for routine replacement therapy?

A

No.

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7
Q

Which class of chemical compounds is used to treat Hyperthyroidism?

A

Thiamides

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8
Q

What are the 2 thiamides used to treat hyperthyroidism?

A

Methimazole and propylthiouracil.

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9
Q

Which is more potent, methimazole or propylthiouracil?

A

Methimazole is 10 times more potent.

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10
Q

Is the half life of methimazole and propylthiouracil long or short?

A

Short plasma half-life.

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11
Q

What is the major contraindication for Thiamides?

A

Pregnancy.

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12
Q

What is the major action of Thiamides?

A

They prevent hormone synthesis by inhibiting thyroid peroxidase. They also block iodine organification.

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13
Q

Do Thiamides have a fast or slow onset of action?

A

Slow because synthesis rather than release of hormones is affected. Requires depletion of T4.

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14
Q

What are the adverse effects of Thiamides?

A

Nausea, GI distress. Infrequently can cause agranulocytosis.

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15
Q

What is Potassium perchlorate used to treat?

A

Hyperthyroidism

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16
Q

What is the action of Potassium perchlorate?

A

It is an anion inhibitor. Competitively inhibits iodide transport.

17
Q

What is the major contraindication for Potassium perchlorate?

A

It is rarely used due to its association with aplastic anemia.

18
Q

What is the action of Iodides?

A

Inhibit hormone release; inhibit organification; Decrease size and vascularity of the hyper plastic gland.

19
Q

What are the contraindications to the use of Iodides?

A

They delay onset of thioamide therapy and prevent use of radioactive iodine due to increase in iodide tissue stores. It also crosses the placenta.

20
Q

What is the action of Radioactive iodine?

A

It destroys the thyroid parenchyma.

21
Q

What is the contraindication to radioactive iodine?

A

Pregnancy.

22
Q

What is the treatment for radioactive contamination?

A

Sodium iodide. It competes out radioactive iodine.

23
Q

What is the action of Propranolol?

A

It is a beta blocker. Blocks the beta adrenergic receptor.

24
Q

What is Propranolol an effective adjunctive therapy for?

A

Thyrotoxicosis.

25
Q

What does Propranolol help alleviate?

A

It alleviates the effects of excess thyroid hormone on the heart and circulation.

26
Q

What are the effects of Propranolol?

A

Reduces breathing rate, excessive sweating, heat intolerance, nervousness and anxiety.

27
Q

True or false: Propranolol affects thyroid hormone levels.

A

False. Propranolol DOES NOT affect thyroid hormone levels.

28
Q

What is Graves disease?

A

It is the most common form of hyperthyroidism. TSH receptor activating antibodies are developed.

29
Q

What is Thyroid Storm?

A

A sudden acute exacerbation of all of the symptoms of thyrotoxicosis.

30
Q

What are the causes of Thyroid storm?

A

Discontinuing needed hyperthyroid medication; over replacement of thyroid hormone; recent treatment with radioactive iodine; severe infection, illness, or stress in a hyperthyroid patient.

31
Q

What is the treatment for Thyroid Storm?

A

Hospitalization; Decrease circulating thyroid hormone levels and decrease their formation. Use PTU or methimazole to decrease thyroid hormone. Use Na iodide or K iodide to inhibit thyroid hormone. Control heart rate by propranolol.

32
Q

Explain the hypothalamic-pituitary-thyroid axis.

A

Hypothalamus secretes thyrotropin releasing hormone (TRH). TRH stimulates synthesis and release of thyrotropin (TSH). TSH increases the synthesis and release of T4 and T3.

33
Q

What is the effect of stress on the thyroid.

A

Stress induces hypothyroidism because it is a negative regulator of the hypothalamus.

Year 2 (9 decks)

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