Weight Loss and Thyroid

Question 1

what labs would you want to check for a pt with thyroid problems on Methimazole or PTU

Answer 1

Thyroid function panel - TSH and T4
LFTs
WBC and CBC (due to risk of agranulocytosis)

Question 2

Prodrug for T3 that is most useful for myxedema coma (an acute hypothyroid state)

Answer 2

Cytomel

Question 3

Pentanoic Acid ester that inhibits gastric and pancreatic lipases
take with a multivitamin

Answer 3

Orlistat

Question 4

converted to active thyroid hormone T3 in the body

Answer 4

T4

Question 5

If pts don’t loose a 5% of total body weight in 12 weeks consider removing them from this drug

Answer 5

Lorcaserin

Question 6

Why do you need to take a multivitamin with Orlistat?

Answer 6

at risk for not absorbing fat soluble vitamins ADEK

Question 7

increases release of norepi and dopamine from nerve terminals in addition to inhibiting their reuptake
avoid using with MAOIs
avoid abrupt withdrawal

Answer 7

Phentermine

Question 8

what meds could be prescribed for symptomatic tx for pt with goiter

Answer 8

Beta Blocker, Iodide, Corticosteroids

Question 9

Phenobarbital, phenytoin, rifampin, and carbamazepine can reduce levels of what thyroid medication? How?

Answer 9

levothyroxine - by inhibiting its metabolism

Question 10

GLP-1 receptor antagonist

avoid use in pts with medullary thyroid cancer

Answer 10

Liraglutide

Question 11

Selectively activates 5HT 2c
avoid in pts with heart failure
avoid with SSRIs, SNRIs, MAOIs

Answer 11

Lorcaserin

Question 12

Methimazole and PTU (propylthiouracil)

Answer 12

thyroid meds

Question 13

mimics iodide and can cause hypothyroidism

Answer 13

Lithium

Question 14

considered the drug of choice for hypothyroidism because its converted to T3 over time

Answer 14

Levothyroxine

Question 15

Can increase plasma iodide levels causing hyperthyroidism and increase thyroid hormone synthesis causing hypothyroidism

Answer 15

Amiodarone