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HRM Week 1 > Thyroid Hormone Pharmacology > Flashcards

Thyroid Hormone Pharmacology Flashcards

1
Q

What is used to treat Hypothyroidism?

A

Thyroid hormone replacement preparations. Levothyroxine (T4), Liothyronine (T3)

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2
Q

What is radioactive iodine 131I used for?

A

Thyroid ablation

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3
Q

What is radioactive iodine 123I used for?

A

Thyroid imaging

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4
Q

What is used to treat hyperthyroidism?

A

Thioamides (aka Thionamides)

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5
Q

What is used to prepare patients for thyroid surgery and prevent iodide organization and thyroid peroxidase reactions to iodinate Tyrosines?

A

Thioamides (aka Thionamides)

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6
Q

What are the three Thioamides?

A

Methimazole (and Carbimazole - metabolizes to methimazole), Propylthiouracil (PTU), Potassium Iodide (KI)

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7
Q

What should you know about Levothyroxine (T4)?

A

Once daily dose. Narrow toxic and therapeutic index. Long half life (7 days), takes 6-8 weeks to reach steady state levels. Absorption variable and incomplete. Dec iron and calcium, AlOH, soy. Lower doses in elderly and those with cardiac risk factors.

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8
Q

What must you do with Levothyroxine in pregnancy?

A

Increase dose by 30-50 percent.

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9
Q

What are adverse effects of iatrogenic hyperthyroidism?

A

Palpitations, tremors, anxiety, weight loss, tachycardia, inc number of bowel movements. Arrhythmia, angina and MI in patients with heart disease. Atrial fibrillation in elderly. Bone loss with chronic over supplementation.

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10
Q

What should you know about Liothyronine, T3?

A

Short onset of 4-6 hours. Half life is about 2 days. Greater potency. Used when quick onset desirable.

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11
Q

What are 6 types of antithyroid drugs?

A

Anion inhibitors, Thioamides, Iodides, Iodinated contrast media 123I, Beta blockers, Radioactive 131I.

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12
Q

What are anion inhibitors?

A

Drugs that impair trapping of iodide

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13
Q

What are Thioamides?

A

Drugs that inhibit thyroid synthesis

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14
Q

What are Iodides?

A

Drugs that impair release and proteolysis of thyroid hormones

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15
Q

What is Iodinated contrast media 123I?

A

Drugs that interfere with T4 to T3 conversion.

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16
Q

What are beta blockers?

A

Drugs that alleviate peripheral symptoms of thyrotoxicosis.

17
Q

What is Radioactive 131I?

A

Drug that destroys the thyroid gland

18
Q

What are the three Thioamides?

A

Methimazole, Carbimazole, Propylthiouracil

19
Q

What are Thioamides used for?

A

Used to treat hyperthyroidism and prepare for thyroid surgery.

20
Q

What is the mechanism of Methimazole and PropylThioUracyl?

A

Inhibit thyroid peroxidase - oxidation of iodide and conjugation reactions producing T3 and T4

21
Q

What is a secondary action of Propylthiouracyl?

A

It also inhibits Deiodinase 1 (thereby inhibiting peripheral conversion of T4 to T3)

22
Q

What other things should you know about Thioamides?

A

Rapid and complete oral absorption. Accumulate in thyroid - duration of action 12 hr for PTU and 24 hr for methimazole. Takes about 2 weeks for effect. First line of defense for Graves’ disease.

23
Q

What is Iodine used for?

A

Preparation for thyroidectomy, to treat thyroid storm and protection from radioactive iodine.

24
Q

What do high concentrations of iodine cause?

A

Inhibits almost all aspects of iodine metabolism including transport, synthesis or iodotyrosines and iodotyronines, and release of thyroid hormone.

25
Q

What are the effects of Iodine treatment?

A

‘Escape’ from iodine treatment can occur. Side effects include allergic reactions, sore teeth and gums, excess salivation.

26
Q

What is 123I?

A

Used to scan thyroid. Thyroid cancer incidence has doubled since 2008, largely attributed to the increased use of thyroid scans. Some critics claim that the increased diagnosis is not beneficial to patients.

27
Q

What is 131I?

A

Used to destroy thyroid. Painless, easy to administer, cheap and effective. Main disadvantage of 131I is too much destruction. Need to supplement Thyroid Hormones after treatment.

28
Q

What remain the cornerstone of treatment in Graves Disease?

A

Antithyroid hormones

29
Q

What is generally recommended for patients with Graves’ disease?

A

A course of 12-18 months of anti-thyroid drugs.

30
Q

What is the recurrence rate of Graves disease?

A

High after discontinuation of anti-thyroid drugs. 30-50 percent of adults are in permanent remission (normal TSH) after drugs. 30 precent of children.

HRM Week 1 (11 decks)

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