Thyroid Hormones and Anti-thyroid Drugs

Question 1

more potent, less highly protein bound, much shorter half-life

Answer 1

T3

Question 2

less potent, more protein bound, much longer half-life

Answer 2

T4

Question 3

T3

Answer 3

liothyronine

Question 4

T4

Answer 4

levothyroxine

Question 5

____ is 5X more potent that ___

Answer 5

T3, T4

Question 6

thyroid physiological effects are mainly due to

Answer 6

T3

Question 7

what type of receptor do T3 and T4 act on?

Answer 7

nuclear

Question 8

the more “natural” thyroid replacement

Answer 8

dessicated thyroid

Question 9

used in surgery for thyroid cancer, maintain suppressive effects while patients are tapered off of other thyroid replacement; short-term support prior to radioiodine

Answer 9

liothyronine

Question 10

patients may need to increase or decrease dose of thyroid during pregnancy, or stay away form it altogether?

Answer 10

increase

Question 11

preferred treatment of myxedema coma

Answer 11

levothyroxine

Question 12

this drug inhibits the peroxidase enzyme, inhibiting iodination and thyroid coupling steps

Answer 12

PTU (propylthiouracil), MMI (methimazole)

Question 13

this drug inhibits conversion of T4 to active T3

Answer 13

PTU

Question 14

useful for immediate control of thyroid hormone production, but not already pre-released TH

Answer 14

PTU, MMI

Question 15

this anti-thyroid is less potent, has a short half-life

Answer 15

PTU

Question 16

this anti-thyroid is more potent, longer acting

Answer 16

MMI

Question 17

what is the better anti-thyroid due to one-a-day dosing and longer plasma half life, non-liver-toxic?

Answer 17

MMI

Question 18

which anti-thyroid is liver toxic?

Answer 18

PTU

Question 19

PTU and MMI can both cause this, symptoms are sore throat and feve

Answer 19

agranulocytosis

Question 20

1st trimester of pregnancy, thyroid storm, which drug do you use?

Answer 20

PTU

Question 21

used in radiation emergencies to compete for uptake of radioactive materials

Answer 21

KI

Question 22

small doses in tracer studies of uptake for diagnosis of hyperthyroidism, localization of metastatic thyroid cancer

Answer 22

radioactive iodine

Question 23

large doses used for destruction of thyroid tissue without damage to other organs

Answer 23

radioactive iodine

Question 24

what drugs are given prior to scheduled radio-iodine treatment? Used to lower TH, increase TSH to maximize radioiodine uptake and also reduce risk of thyroid storm

Answer 24

MMI, PTU

Question 25

once thyroid gland is destroyed, use this as replacement for subsequent hypothyroidism

Answer 25

levothyroxine

Question 26

when thyroid cancer present, anti-thyroid drug fails during pregnancy, or if patients refuse radioiodine

Answer 26

thyroidectomy

Question 27

Best treatment for Graves disease

Answer 27

thyroidectomy

Question 28

Role of drugs in thyroidectomy entire regimen

Answer 28

thioamides (MMI, PTU) 6 wks prior
Iodine 2 wks prior to decrease size and vascularity
surgically remove
Levothyroxine to replace

Question 29

choice of hyperthyroidism treatment: children

Answer 29

MMI

Question 30

choice of hyperthyroidism treatment: elderly

Answer 30

radioactive iodine

Question 31

choice of hyperthyroidism treatment: pregnancy

Answer 31

PTU, surgery

Question 32

choice of hyperthyroidism treatment: Graves disease

Answer 32

surgery

Question 33

choice of hyperthyroidism treatment: thyroid storm – just flip it and look

Answer 33

iodine (decreases release of preformed thyroid), PTU (prevents T4–>T3 conversion), glucocorticoids

propranolol, others for symptomatic relief