thyroid hormones Flashcards
T_ is the active form in the body
3
Hashimoto’s is associated with ____thyroid
HYPO
Graves is associated with ___thyroid
HYPER
cold intolerance is with ____ and heat intolerance is with ____
hypo, hyper
myxedema coma is with ____ and thyroid storm is with ____
hypo, hyper
____ is made from desseicated animal thyroid
armour thyroid
composition of t4 to t3 in armour thyroid is
4:1
which drug is pure T4 that still needs to be converted
Levothyroxine (synthroid)
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
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
which drug is the active form of T3
liothyronine (cytomel)
T/F synthroid is more potent than liothyronine
FALSE - liothyronine is 2.5-3x as potent
whats the issue with liothyonine (pure T3)
higher incidence of cardio side effects
PTU and Methimazole (tapazole) are what kind of drugs
Antithyroid
how do PTU and Methimazole (tapazole) work?
[these are antithyroid meds]
- block synthesis of thyroid hormone
- block the peripheral do iodination of T4 to T3 (block the enzyme reaction)
which drugs are useful in treating thyroid storm before thyroidectomy
PTU and Methimazole (tapazole)
S/E of antithyroid meds include:
think: L A H
lupus
arthraligias
hematologic
so transient leucopenia, rash, granulocyctosis early in therapy
which drug brings to the thyroid glad and inhibits the release of thyroid hormone into the circulation
iodine
____ + propranolol is used for the tx of hyperthyroidism before thyroidectomy
iodine
T/F thyroid storm is more likely to occur in the first 6-19h post op than intraop
TRUE
she also says “abrupt onset”
why should you avoid ASA for elevated temps in thyroid storm
it may displace thyroxine from carrier proteins
pharm Tx of thyroid storm- 5 things
- IV cold crystalloids
- sodium iodide
- cortisol iv
- propranolol iv
- ptu
