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Thyroid Disorders Background & Treatment
Thyroid Disorders Background & Treatment
37
Pharmacology
Professional
08/30/2012

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Cards

Term
What does the thyroid do?
Definition

Controls how quickly the body burns energy, makes proteins, and controls how sensitive the body should be to other hormones.

Term

Which is more common, hypothyroidism or hyperthyroidism?

Definition

Hypothyroidism is more common and can occur in all age groups.

[image][image][image][image]Wikipedia: hypo definition: hypochondria.

Term
Which hormones does the thyroid produce?
Definition
Thyroxine (T4) and Triiodothyronine (T3)
Term
T3 and T4 are both formed from?
Definition
Iodine and tyrosine
Term
Describe the normal functioning of the thyroid gland
Definition

thyroid - stimulating hormone (TSH) stimulates the secretion of thyroxine (T4), which is converted to T3 (which is 4x more potent than T4).

 

T4 inhibits the secretion of TSH; thus a negative feedback loop is created.

Term

Describe the hormone levels in hypothyroidism

Definition
Hypothyroidism: low T4, hight TSH
Term
Describe hormone levels in hyperthyroidism
Definition
Hyperthyroidism: high T4, low TSH
Term
The most commone cause of hypothyroidim is?
Definition

Hashimoto's Disease, an autoimmune condition in which a patient's antibodies attack their thyroid gland.

[image][image][image][image]

Term
What are the two drugs common for causing hypothyroidism?
Definition
lithium and amiodarone
Term
Diagnosis for hypothyroidism (lab values)
Definition

Low free thyroxine (FT4): normal range 0.8 - 3.0 uIU/mL

 

High thyroid stimulaitng hormone (TSH): normal range 0.3 - 3.0 uIU/mL

[image][image][image][image]

Term
Describe pergnancy and hypothyroidism
Definition

Levothyroxine is FDA pregnancy category A. Pregnant women with thyroid hormone deficiency or TSH elevation during pregnancy may have children at risk of impairment in their intellectual function and motor skills. Pregnancy women being treated with thyroid hormone replacement require a 30 - 50% increase in the levothyroxine dose.

Term
Levothyroxine is T3 or T4?
Definition

T4

 

Though, T4 is ultimately converted to T3 (the more active form)

Term
Brand name for levothyroxine
Definition
Synthroid, Levothroid, Levoxyl
Term
Pregnancy category of levothyroxine
Definition
Preg Category A
Term
Levothyroxine is preferred b/c of?
Definition

once-daily dosing, is inexpensive, and has more uniform potency

Term
[image]
Definition
Statement. Not a question.
Term

Basically, take this medication by itself seperate from other medications due to drug interactions that decrease the drugs absorption.

Definition
Statement. Not a question.
Term
How should levothyroxine be taken?
Definition

On an empty stomach with a full glass of water 30 minutes before breakfast.

Term
What are some "aesthetic" indiations of hyperthyroidism
Definition
Goiter and exopthalmus
Term
What can hyperthyroidism lead to?
Definition

tachycardia, arrhythmias, heart failure and osteoporosis.

Term
Should thyroid hormone be used to lose weight?
Definition

No on should be using thyroid hormone to lose weight - they will be irritable (obnoxious) and can end up with severe cardiac complications.

Term
What is the most common cause of hyperthyroidism?
Definition

Grave's disease; which tends to occur in females in the 30s and 40s. It's an autoimmue disease in which one's own antibodies stimulate the thyroid gland.

Term
Name the most common drugs that can cause hyperthyroidism?
Definition
iodine; amiodarone; interferons
Term
The general treatment of treating hyperthyroidism
Definition

Destorying all or part of the gland via radioactive iodine (RAI - 131) or surgery.

Term
Treatment of choice in Grave's disease
Definition
RAI-131
Term
Role of beta blockers in treating hyperthyroidism
Definition

Symptom control (to reduce palpitations, tremor and tachycardia).

 

Term

PTU or _______ can be used as a temporary measure untill surgery is complete (in hyperthyroidism).

Definition
methimazole
Term
MOA of thionamides
Definition

inhibit synthesis of thyroid hormone by blocking the oxidation of iodine in the thyroid gland; PTU also inhibits peripheral conversion of T4 to T3.

Term
Propythiouracil (PTU) typical daily dosing?
Definition
50 mg BID - TID
Term
PTU has black box warning for?
Definition

liver damage, be seen at once if develop yellow skin, hih fever, or severe sore throat.

Term
Can PTU be used in pregnant women to treat hyperthyroidism?
Definition

Caution in pregnant women (preg cat D): PTU for women trying to conceive or in 1st trimester - change to methimazole for 2nd and 3rd trimesters.

Term
Brand name for methimazole
Definition
Tapazole
Term
If PTU and methimazole help treat hyperthyoridism, then why have surgery?
Definition

Main shortcomming: have to be taken for life, if stopped at all symptoms reappear - for this reason most get more permanent treatment (surgery).

Term
[image]
Definition

Statement. Not a question.

 

Term
Describe thryoid storm
Definition

Thyroid storm is rare but serious and can happen in patients with hyperthyroidism, due to a particularly stressful event (infection, MI, diabetes, childbirth) and occasionally due to lack of treatment. It can also be due to extreme emotional stress. Thyroid storm can be fatal; patients with hyperthyroidism will need to try and live as stree - free as possible and should be able to recognize the symptoms of thyroid storm. They should understand that this is a medical emergency.

Term
Clincial signs and symptoms of thyroid storm
Definition

Fever (> 103 degrees F)

Tachycardia

Tachypnea

Profuse sweating

Agitation

Psychosis

Coma

 

Term
Treatments for thyroid storm
Definition
[image]
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