Thyroid Problems

Question 0

Levothyroxine (T4)

Brands, Route, Side Effects, Need to know

Answer 0

Brand: Levothirod, Levoxyl, Synthroid, Tirosint, Unithroid
Rt: Mouth or IV
Side Effects:
- common: anxiety, insomnia, tremors, tachycardia, palpating, angina, dysrhythmias
- life threatening: Thyroid storm, cardiac arrest
Need to Know:
-contact prescriber if vaginal itching, loose, foul-smelling stools; furry tongue; if diarrhea with blood or puss
-take product 2 hours before or after antacids, iron, calcium, zinc
-complete full course of therapy
-avoid hazardous activities
-use frequent rinsing of mouth, sugarless candy or gum for dry mouth
-avoid other medication unless approved by provider
-prevent/limit exposure to sun

Question 1

What drugs are used to treat hypothyroidism?

Answer 1

G: Levothyroxine (T4)
G: Liothyronine (T3)
G: Liotrix (T3 or T4)

Question 2

What is hypothyroidism?

Answer 2

Abnormally low activity of the thyroid gland, resulting in retardation of growth and mental development in children and adults

Question 3

What is hyperthyroidism?

Answer 3

Overactive thyroid or hyperthyrosis
Condition which the thyroid gland produces and secrets excessive amounts of the free thyroid hormones-triiodothyronine (T3) and/or thyroxine (T4)

Question 4

What disease is the most common cause of hyperthyroidism?

Answer 4

Graves’ Disease

Question 5

What are the signs and symptoms of hypothyroidism?

Answer 5

• Coarse & thinning hair, dry skin, brittle nails, yellowish skin, slow body movements, cold skin, inability to tolerate cold, tired, sluggish or weak, memory problems or problems concentrating, depression, constipation, heavy or irregular menstrual periods that last longer than 5-7 days, weight gain (usually 10 pounds or less)

Question 6

What are the signs and symptoms of hyperthyroidism?

Answer 6

• Feel nervous, weak, or tired, have hand tremors, or have a fast or irregular heartbeat, or have trouble breathing even when resting, feel hot, sweaty or have warm, red skin that may be itchy, have frequent and sometimes loose bowl movements, have fine, soft hair that is falling out, lose weight even though eating normally or more than usual

Question 7

What are the actions of all hypothyroid drugs?

Answer 7

Increases metabolic rate
Controls protein synthesis
Increases cardiac output, renal blood flow, oxygen consumption, body temperature, blood volume, growth, cellular development

Question 8

What are the contraindications of all hypothyroid drugs?

Answer 8

Adrenal insufficiency 
Thyrotoxicosis
Hypersensitivity to beef
Alcohol intolerance (from injection only)
Untreated hypertension

Question 9

Is there any black box warning?

Answer 9

Yes, obesity treatment

Question 10

What are the actions of Methimazole and what is it used to treat?

Answer 10

Used to treat hyperthyroidism
Inhibits synthesis of thyroid hormones by decreasing iodine use in manufacture of thyroglobin and iodothyroine, does not affect circulatory T3 or T4

Question 11

What are the contraindications of Methimazole?

Answer 11

Pregnancy, breastfeeding, hypersensitivity

Question 12

Are there any black box warnings for Methimazole?

Answer 12

No

Question 13

What is propylthiouracil used to treat for? And what are the actions?

Answer 13

Used for hyperthyroidism

Blocks synthesis peripherally of T3,T4, inhibits organification of iodine

Question 14

What are the propylthiouracil contraindications?

Answer 14

Pregnancy, breastfeeding, hypersensitivity, agranulocytosis, hepatitis, jaundice

Question 15

Does propylthiouracil have any black box warnings?

Answer 15

Yes, hepatic disease