Thyroid & Parathyroid Agents

Question 1

What are the actions of the thyroid gland?

Answer 1

• Produces two thyroid hormones using iodine found in the diet (T3 & T4)
• Removes iodine from the blood, concentrates it, and prepares to for attachment to tyrosine, an amino acid

Question 2

What are the functions of the thyroid hormone?

Answer 2

Regulate the rate of metabolism
Affect heat production and body temperature
Affect oxygen consumption, cardiac output, blood volume
Affect enzyme system activity
Affect metabolism of carbs, fats, and proteins
Regulate growth and development

Question 3

What are the two types of thyroid dysfunction?

Answer 3

Hypothyroidism

Hyperthyroidism

Question 4

Hypothyroidism is the under-activity of the thyroid

Answer 4

True

Question 5

Hyperthyroidism is the overactivity of the thyroid

Answer 5

True

Question 6

Low thyroid function causes high TSH

Answer 6

True

Question 7

What is the normal range of TSH

Answer 7

.5-4.5

Question 8

High thyroid function causes low TSH

Answer 8

True

Question 9

Low TSH represents hyperthyroidism

Answer 9

True

Question 10

What are the causes of hypothyroidism

Answer 10

Absence of the thyroid gland
Lack of sufficient iodine in diet to produce needed levels of thyroid hormone
Lack of sufficient functioning thyroid tissue due to tumor or autoimmune disorders
Lack of TRH related to a tumor or disorder of the hypothalamus

Question 11

What are the replacement hormone products for treating hypothyroidism

Answer 11

Levothyroxine (synthroid) 
Thyroid Desiccated (Armour Thyroid) prepared from from dried animal thyroid glands and contain both T3 & T4

Question 12

Indication of thyroid hormone

Answer 12

Replacement therapy in hypothyroidism; pituitary TSH suppression in the treatment of euthyroid gaiters, management of thyroid cancer; thyrotoxicosis in conjunction with other therapy; myxedema coma

Question 13

Pharmacokinetics of thyroid hormone

Answer 13

Absorbed in GI tract and bound to serum proteins
Elimination is in bile
Does not cross the placenta

Question 14

Contraindications for thyroid hormone

Answer 14

Known allergy
Thyrotoxicosis (too much thyroid hormone)
Acute MI

Question 15

Caution when using thyroid hormone

Answer 15

Lactation

Hypoadrenal conditions such as Addison’s

Question 16

Thyroid hormone exposed to children through lactation can cause growth and development problems

Answer 16

True

Question 17

Adverse effects of thyroid hormone

Answer 17

Skin reactions
Symptoms of hyperthyroidism
Cardiac stimulation
CNS effects

Question 18

Drug-Drug interactions with thyroid hormone

Answer 18

Cholestyramine
Oral anticoagulants
Digitalis
Theophylline

Question 19

Levothyroxine is the prototype for thyroid hormone

Answer 19

True

Question 20

What causes hyperthyroidism

Answer 20

Graves’ disease

Question 21

Signs and symptoms of hyperthyroidism

Answer 21

Increased body temperature Flushing
Tachycardia Intolerance to heat
Think skin. Amenorrhea
Palpitations Weight loss
Hypertension Goiter

Question 22

What are the actions of antithyroid agents

Answer 22

Thioamides prevent the formation of thyroid hormone within the thyroid cells, lowering the serum level of thyroid hormone
Partially inhibits the conversion of T4 to T3

Question 23

Indications with antithyroid agents

Answer 23

Hyperthyroidism

Question 24

Pharmacokinetics of antithyroid agents

Answer 24

Well absorbed from GI tract and then concentrated in the thyroid gland
Some excretion can be detected in urine

Question 25

Contraindications of antithyroid agents

Answer 25

Known allergy | Pregnancy

Question 26

Cautions with antithyroid agents

Answer 26

Lactation

Question 27

Adverse effects of antithyroid agents

Answer 27

Thyroid suppression

Question 28

Drug-drug interactions with antithyroid agents

Answer 28

``` Oral anticoagulants Theophylline Metoprolol Propranolol Digitalis ```

Question 29

Propylthiouracil is the prototype for antithyroid agents

Answer 29

True

Question 30

Propylthiouracil is used for the treatment of hypothyroidism

Answer 30

True

Question 31

The thyroid gland uses iodine to produce the thyroid hormones

Answer 31

True

Question 32

What is hypoparathyroidism

Answer 32

The absence of parathormone | Most likely to occurs with the accidental removal of the parathyroid glands during thyroid surgery

Question 33

What is hyperparathyroidism

Answer 33

The excessive production of parathormone | Can occurs as a result of parathyroid tumor or certain genetic disorders

Question 34

What are antihypocalcemic agents

Answer 34

Agents used for stimulation of osteoclasts or bone cells to release calcium from the bone Increased intestinal absorption of calcium Increased calcium resorption from the kidneys Stimulation of cells in the kidney to produce calcitriol

Question 35

Indications for antihypocalcemic agents

Answer 35

Management of hypocalcemia in patients undergoing chronic renal dialysis Treatment of hypoparathyroidism

Question 36

Pharmacokinetics of antihypocalcemic agents

Answer 36

Absorbed from GI tract and widely distributed throughout the body Stored in liver, fat, muscle, skin, and bones Metabolized in the liver, excreted in the urine

Question 37

Contraindications of antihypocalcemic agents

Answer 37

Allergy to vitamin D Hypercalcemia Vitamin D toxicity Pregnancy

Question 38

Caution with antihypocalcemic agents

Answer 38

History of renal stones

Question 39

Adverse effects of antihypocalcemic agents

Answer 39

GI effects | CNS effects

Question 40

Drug-drug interactions with antihypocalcemic agents

Answer 40

Magnesium containing antacids | Cholestyramine or mineral oil

Question 41

Prototype for antihypocalcemic agents

Answer 41

Calcitriol

Question 42

Antihypercalcemic agents are used to

Answer 42

Treat PTH excess or hypercalcemia | Act on the serum levels of calcium and do not suppress the parathyroid gland or PTH

Question 43

What are the antihypercalcemic agents

Answer 43

Bisphosphonates | Calcitonins

Question 44

Alendronate (fosamax), ibandronate (Boniva), risedronate (actonel) are all bisphosphonates

Answer 44

True

Question 45

Bisphosphonates should be taken in the AM with a full glass of water, 30 minutes prior to food and drink Must remain upright for at least 30 minutes after

Answer 45

True

Question 46

Alendronate is the prototype for antihypercalcemic agents-bisphosphonates

Answer 46

True

Question 47

What is alendronate used to treat

Answer 47

Osteoporosis

Question 48

Prototype for antihypercalcemic agents - calcitonins

Answer 48

Calcitonin salmon