Thyroid drugs

Question 1

What is the mechanism of action by which propranolol can help treat hyperthyroidism?

Answer 1

Alleviate cardiac symptoms and block peripheral conversion of T4 to T3

Question 2

What is the most stable and uniform treatment for hypothyroidism

Answer 2

Levothyroxine

Question 3

What drug class prevents T4 / T3 synthesis by blocking iodine organification and coupling of the iodotyrosines?

Answer 3

thiamides

Question 4

Does salicylate increase or decrease TBG binding to thyroid hormone?

Answer 4

decrease

Question 5

What is the key regulated step of thyroid hormone synthesis?

Answer 5

Uptake of iodide into follicular cells.

Question 6

What is first-line therapy for Grave’s disease?

Answer 6

Radioactive iodine ablation

Question 7

Your patient’s insurance has changed and she wants to switch to the generic brand of levothyroxine. Is this advisable?

Answer 7

No, there could be as much as a 10% difference between “equivalent products”

Question 8

Which treatment for hypothyroidism is antigenic?

Answer 8

Thyroid USP

Question 9

What drug class is Lugol’s solution?

Answer 9

Iodide (potassium iodide and iodide)

Question 10

What drug class is PTU?

Answer 10

thiamides

Question 11

4:1 mixture T4 and T3

Answer 11

Liotrix

Question 12

Which treatment of hyperthyroidism increases the risk of agranulocytosis?

Answer 12

thiamides

Question 13

Where is T4 absorbed in the gut?

Answer 13

ileum and colon

Question 14

Does estrogen increase or decrease TBG binding to thyroid hormone?

Answer 14

increase

Question 15

What drug class is methimazole?

Answer 15

thiamides

Question 16

What treatment for hypercholesterolemia interfere with levothyroxine absorption?

Answer 16

bile acid sequestrants. ie: cholestyramine

Question 17

Synthetic T3

Answer 17

Liothyronine

Question 18

Porcine thyroid extract

Answer 18

Thyroid USP

Question 19

Synthetic T4

Answer 19

Levothyroxine

Question 20

Does levothyroxine have a narrow or wide therapeutic window

Answer 20

narrow therapeutic window

Question 21

Are thiamides indicated in thyrotoxicosis or thyroiditis?

Answer 21

thyroitoxicosis

Question 22

How long does it take for thyroid replacement therapy to reach steady-state plasma levels?

Answer 22

6-8weeks

Question 23

Which treatment can be used prior to surgery to decrease the size and hypervascularity of a hyperplastic thyroid gland?

Answer 23

Iodide

Question 24

What treatment for acid reflux could interfere with levothyroxine absorption?

Answer 24

antiacids. ie: calcium carbonate

Question 25

What drug class is SSKI?

Answer 25

Iodide (potassium iodide)

Question 26

What radioactive iodide isotope is used for ablation therapy?

Answer 26

I-131

Question 27

Which thiamides is safer in pregnancy?

Answer 27

PTU (more protein bound)

Question 28

What is the enzyme involved in iodide organification of tyrosine residues on thyroglobulin?

Answer 28

thyroid peroxidase

Question 29

In the setting of thyroid storm, a patient is given propranolol, IV potassium iodide, and PTU. What other drug is indicated here?

Answer 29

Hydrocortisone

Question 30

What anti-inflammatory treatment increases peripheral metabolism of T4?

Answer 30

glucocorticoids