thyroid hormones

Question 1

T_ is the active form in the body

Answer 1

3

Question 2

Hashimoto’s is associated with ____thyroid

Answer 2

HYPO

Question 3

Graves is associated with ___thyroid

Answer 3

HYPER

Question 4

cold intolerance is with ____ and heat intolerance is with ____

Answer 4

hypo, hyper

Question 5

myxedema coma is with ____ and thyroid storm is with ____

Answer 5

hypo, hyper

Question 6

____ is made from desseicated animal thyroid

Answer 6

armour thyroid

Question 7

composition of t4 to t3 in armour thyroid is

Answer 7

4:1

Question 8

which drug is pure T4 that still needs to be converted

Answer 8

Levothyroxine (synthroid)

Question 9

T/F Synthroid has a long elimination half time (7 days) so patients unable to take PO meds do not require immediate replacement IV form

Answer 9

TRUE - so NO thyroid crisis, fine to hold.

even when you change the dose you wait 6-8 weeks to recheck

after 7 days give half the oral dose IV

Question 10

which drug is the active form of T3

Answer 10

liothyronine (cytomel)

Question 11

T/F synthroid is more potent than liothyronine

Answer 11

FALSE - liothyronine is 2.5-3x as potent

Question 12

whats the issue with liothyonine (pure T3)

Answer 12

higher incidence of cardio side effects

Question 13

PTU and Methimazole (tapazole) are what kind of drugs

Answer 13

Antithyroid

Question 14

how do PTU and Methimazole (tapazole) work?

[these are antithyroid meds]

Answer 14

• block synthesis of thyroid hormone

- block the peripheral do iodination of T4 to T3 (block the enzyme reaction)

Question 15

which drugs are useful in treating thyroid storm before thyroidectomy

Answer 15

PTU and Methimazole (tapazole)

Question 16

S/E of antithyroid meds include:

think: L A H

Answer 16

lupus
arthraligias
hematologic

so transient leucopenia, rash, granulocyctosis early in therapy

Question 17

which drug brings to the thyroid glad and inhibits the release of thyroid hormone into the circulation

Answer 17

iodine

Question 18

____ + propranolol is used for the tx of hyperthyroidism before thyroidectomy

Answer 18

iodine

Question 19

T/F thyroid storm is more likely to occur in the first 6-19h post op than intraop

Answer 19

TRUE

she also says “abrupt onset”

Question 20

why should you avoid ASA for elevated temps in thyroid storm

Answer 20

it may displace thyroxine from carrier proteins

Question 21

pharm Tx of thyroid storm- 5 things

Answer 21

• IV cold crystalloids
• sodium iodide
• cortisol iv
• propranolol iv
• ptu