Thyroid Pharm Flashcards
__ is the major thyroid hormone replacement drug because of its
T4 Levothyroxine; longer half life
T3 is only used for
myxedema coma (severe hypothyroidism)
Side effects for thyroid hormone replacements are due to
inappropriate dosing
Give __ dose of thyroid hormone in older patients bc
less; they don’t clear it well
Two common ions that decrease LT4 absorption
iron, calcium
Condition that decreases LT4 absorption
small intestinal disease
Increased TSH on therapy may be due to
increased TBG
This NT and high dose ___ lower TSH
dopamine, glucocorticoids
Self administration of ___ can cause low TSH
LT4
Two situations where TSH is very important
pregnancy, thyroid cancer
Antithyroid drugs take ___ to start working
2-4 weeks
PTU is ___ bound and decreases __ to _ converstion
protein; T4-T3
Use methimazole in all Grave’s disease patients except
first trimester of pregnancy, thyroid storm, adverse rxn to methimazole
Major side effect of antithyroid drugs
Agranulocytosis
Severe hepatitis is a severe side effect of
PTU
Use ____ to thyrotoxicosis of any etiology
Beta Blockers
Use __ in subacute thyroidosis
NSAIDS
Wolff-Chaikoff Effect
What it is and how it affects normal and abnormal thyroids
• 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
Jod-Basedow Phenomenon
What it is and when it occurs
Thyrotoxicosis produced by iodine
exposure
• Occurs in nodular thyroid glands
Radioiodine low and high dose purposes
Low- diagnostics
high- therapeutics
Amiodarone is used for arrhythmias, but can cause hyperthyroidism in two types. Describe them
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.
