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Pharmacology > Unit 5-Thyroid > Flashcards

Unit 5-Thyroid Flashcards

1
Q

Levothyroxine sodium

Drug class

A

Synthetic thyroid hormone (T4)

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2
Q

Levothyroxine sodium

Mechanism

A

Converted to T3 in liver; T3 binds toTR complex to influence gene expression

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3
Q

Levothyroxine sodium

Uses

A

Drug of choice for hypothyroidism (longer half-life than T3)

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4
Q

Levothyroxine sodium

Side effects

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

“Start low, go slow” in patients with angina pectoris, CAD, and elderly; requires periodic monitoring and adjustment (especially during pregnancy); not effective in Chronic Fatigue Syndrome

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5
Q

Liothyronine sodium

Drug class

A

Synthetic thyroid hormone (T3)

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6
Q

Liothyronine sodium
Mechanism

A

T3 binds to TR complex in nucleus to influence gene expression

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7
Q

Liothyronine sodium

Uses

A

Acute management of hypothyroidism (rapid effect);

myxedema coma (IV formulation)

4X as potent as T4, but not desirable for chronic replacement (less stable, more costly, transient high levels)

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8
Q

Liothyronine sodium

Side effects

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

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9
Q

Liotrix

Drug class

A

Synthetic thyroid hormone (T4 & T3)

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10
Q

Liotrix

Mechanism

A

Converted to T3 in liver; T3 binds toTR complex to influence gene expression

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11
Q

Liotrix

Uses

A

Thyroid hormone replacement therapy (4:1 mix of T4:T3; not used much)

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12
Q

Liotrix

Side effects

A

Hyperthyroidism: heart palpitations, nervousness, shaking, heat intolerance, weight loss

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13
Q

Propylthiouracil

Drug class

A

Thioamide (thyroid peroxidase inhibitors)

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14
Q

Propylthiouracil

Mechanism

A

Inhibit organification of iodide and coupling of iodotyrosine; also reduces peripheral deiodination of T4 to T3

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15
Q

Propylthiouracil

Uses

A

Hyperthyroidism; thyrotoxicosis (high dose); drug of choice for hyperthyroidism during pregnancy

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16
Q

Propylthiouracil

Side effects

A

Rare side effects: hepatitis, agranulocytosis (higher than methimazole), lupus-like syndrome

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus

17
Q

Methimazole

Drug class

A

Thioamide (thyroid peroxidase inhibitors)

18
Q

Methimazole

Mechanism

A

Inhibit organification of iodide and coupling of iodotyrosine; active metabolite of carbimazole; less effect on T4 to T3 conversion

19
Q

Methimazole

Uses

A

Hyperthyroidism; thyrotoxicosis (high dose)

20
Q

Methimazole

Side effects

A

Rare side effects: hepatitis, agranulocytosis (less than propylthiouracil), lupus-like syndrome

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus

Methimazole is a possible teratogen

21
Q

Carbimazole

Drug class

A

Thioamide (thyroid peroxidase inhibitors)

22
Q

Carbimazole

Mechanism

A

Prodrug converted to methimazole; Inhibits organification of iodide and coupling of iodotyrosine; less effect on T4 to T3 conversion

23
Q

Carbimazole

Uses

A

Hyperthyroidism; thyrotoxicosis (high dose)

24
Q

Carbimazole

Side effects

A

Rare side effects: hepatitis, agranulocytosis, lupus-like syndrome

Discontinue and use radio-iodine if patient develops agranulocytosis or drug-induced lupus; not available in US

25
Q

Radioactive Iodine

Drug class

A

Radioactive isotope

26
Q

Radioactive Iodine

Mechanism

A

Radioactive agent that emits beta particles and gamma rays that destroy thyroid cells

27
Q

Radioactive Iodine

Uses

A

Treatment of choice for hyperthyroidism after antithyroid drug therapy; ablation after cancer

28
Q

Radioactive Iodine

Side effects

A

Transient or permanent hypothyroidism; increases cancer risk

Contraindicated in pregnant/breast feeding, patients under 10; monitor serum thyroid hormones post-treatment every 2-3 months for first year

29
Q

β-blockers

Mechanism

A

Reduce sympathetic tone

30
Q

β-blockers

Uses

A

Symptomatic treatment of hyperthyroidism (no effect on T3 synthesis)

31
Q

β-blockers

Side effects

A

Do not use on patient’s at risk of heart failure! Discontinue use when patient returns to euthyuroid.

Pharmacology (26 decks)

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