Thyroid Disorders

vitohuxo's version from 2016-03-10 01:37


Question Answer
the thyroid gland is the only cells that have the ability to absorbiodine
important to measure free T4 since this is the active form
hypothyroidismdeficiency T4 and elevation TSH
hyperthyroidismover secretion T4 and decrease TSH
hypothyroidism symptomsweight gain and fatigue, also cold, dry skin, muscle cramps, voice changes, constipation, goiter
autoimmune hypothyroidism hashimoto's disease
myxedema coma life threatening emergency= poor metabolism, circulation, and hypothermia.
drugs that can cause hypothyroidismamiodarone, carbamazepine, interferons, lithium, oxcarbazepine, tyrosine kinase inhibitors (sunitab)
diagnosis hypothyroidismlow T4 (below 0.9 to 2.3 ng/dL) high TSH (normal 0.3 to 3)
too high of a thyroid replacement dose can lead toa fib and fractures.
levothyroxine in pregnancycategory A. should be treating. need 30-50% increase in the dose!
how to take levothyroxine60 mins before breakfast or at bedtime (at least 3 hrs after last meal).
known CAD then start with what dose synthroid?12.5 to 25mcg daily (warning to decrease dose in CV disease)
check TSH levels and clinical symptomsevery 4-6 weeks until levels are normal
levothyroxine is drug of choice becausechemical stability, once daily dosing, low cost, more uniform potency
thyroid USP (armour)porcine derived. contains T3 and T4. less predictable potency and stability. some feel better using.
liothyronineT3. shorter half life causes fluctuations in T3 levels
levothyroxine tablet colorsOrangutans will vomit on you right before they become large proud giants. 25=orange, 50=white, 75= violet, 88=olive, 100=yellow, 112=rose, 125=brown, 137=turqioise, 150=blue, 175= lilac, 200=pink, 300=green
hyperthyroidism autoimmune disease causegraves disease
drugs that can cause hyperthyroidismiodine, amiodarone, interferons
treatment of choice for graves diseaseradioactive iodine
can use this for symptom control with any option in hyperthyroidismbeta blockers
initially when treating hyperthyroidism with drugs, it takes ___ at higher doses to control symptoms1-3 months. at which point the dose is reduced.
propylthiouracil (PTU)med for hyperthyroidism. not first line.
methimazole (tapazole)med for hyperthyroidism.
med in pregnancy for hyperthyroidism1st trimester PTU then 2/3 methimazole.
boxed warning for PTUsevere liver injury and acute liver failure.
PTU/methimazole SEGI upset, hepatitis, agranulocytosis (rare)
___ is preferred in thyroid stormPTU + inorganic iodide therapy + beta blocker + systemic steroid + aggressive cooling with APAP and cooling blankets and other measures like fluids and insulin
methimazole/PTU moainhibit synthesis of thryoid hormones by blocking oxidation of iodine in the thyroid gland and PTU also inhibits peripheral conversion of T4 to T3
starting dose under 50 synthroid1.6mcg/kg/day
starting dose if over 50 synthroid0.5 mcg/kg/day
drugs can decrease thryoid hormone levelsantacids, calcium, cholestryramine, mangesium, multivitamins, orlistat, kayexalate, sucraflfate, lanthanum, patiromer, dilantin

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