Thyroid Pharm

Question 1

__ is the major thyroid hormone replacement drug because of its

Answer 1

T4 Levothyroxine; longer half life

Question 2

T3 is only used for

Answer 2

myxedema coma (severe hypothyroidism)

Question 3

Side effects for thyroid hormone replacements are due to

Answer 3

inappropriate dosing

Question 4

Give __ dose of thyroid hormone in older patients bc

Answer 4

less; they don’t clear it well

Question 5

Two common ions that decrease LT4 absorption

Answer 5

iron, calcium

Question 6

Condition that decreases LT4 absorption

Answer 6

small intestinal disease

Question 7

Increased TSH on therapy may be due to

Answer 7

increased TBG

Question 8

This NT and high dose ___ lower TSH

Answer 8

dopamine, glucocorticoids

Question 9

Self administration of ___ can cause low TSH

Answer 9

LT4

Question 10

Two situations where TSH is very important

Answer 10

pregnancy, thyroid cancer

Question 11

Antithyroid drugs take ___ to start working

Answer 11

2-4 weeks

Question 12

PTU is ___ bound and decreases __ to _ converstion

Answer 12

protein; T4-T3

Question 13

Use methimazole in all Grave’s disease patients except

Answer 13

first trimester of pregnancy, thyroid storm, adverse rxn to methimazole

Question 14

Major side effect of antithyroid drugs

Answer 14

Agranulocytosis

Question 15

Severe hepatitis is a severe side effect of

Answer 15

PTU

Question 16

Use ____ to thyrotoxicosis of any etiology

Answer 16

Beta Blockers

Question 17

Use __ in subacute thyroidosis

Answer 17

NSAIDS

Question 18

Wolff-Chaikoff Effect

What it is and how it affects normal and abnormal thyroids

Answer 18

• Excess iodide transiently inhibits thyroid
iodide organification (step 2)
– In individuals with a normal thyroid, the
gland escapes from this inhibitory effect
– In individuals with underlying autoimmune
thyroid disease (Hashimoto’s thyroiditis or
Graves’ disease), the suppressive effect
may persist

Question 19

Jod-Basedow Phenomenon

What it is and when it occurs

Answer 19

Thyrotoxicosis produced by iodine
exposure
• Occurs in nodular thyroid glands

Question 20

Radioiodine low and high dose purposes

Answer 20

Low- diagnostics

high- therapeutics

Question 21

Amiodarone is used for arrhythmias, but can cause hyperthyroidism in two types. Describe them

Answer 21

Type 1 in patients with underlying thyroid nodular
disease or Graves’ disease—increased thyroid
hormone production, Iodine effect
Type 2 in patients with normal thyroids—
destructive thyroiditis— increased thyroid hormone
release, Direct toxic effect of amiodarone.