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ch. 58
drugs for thyroid disorders
| Question | Answer |
|---|---|
| Hypothyroidism | Mild deficiency of thyroid hormone |
| Myxedema | Severe deficiency of thyroid hormones |
| Cretinism | Hypothyroidism in infants |
| Test to determine levels of thyroid in the blood | serum TSH |
| Hashimoto’s thyroiditis | insufficient iodine (surgery, diet, or removal of thyroid) |
| Results in adult hyortyroidism | Insufficient secretion of TSH and TRH |
| Treatment of hypothyroidism in infants | Replacement therapy with thyroid hormones |
| Grave's disease | most common cause of excessive thyroid secretion |
| Clinical manifestations of hyperthyroidism (thyrotoxicosis) | increased body temperature, weakened skeletal muscles, insomnia, warm&moist skin, intolerance to heat |
| What causes exopthalmos? | infiltration of the extraocular muscles and orbital fat by lymphocytes, macrophages, plasma cells, mast cells, and mucopolysaccharides mediated by the immune system |
| Treatment for Grave's disease | (1) surgical removal of thyroid tissue, (2) destruction of thyroid tissue with radioactive iodine, and (3) suppression of thyroid hormone synthesis with an antithyroid drug (methimazole or propylthiouracil) |
| adjuntive therapy for hyperthyroidism | beta blockers and non-radioactive iodine |
| Thyrotoxic crisis | profound hyperthermia (105°F or even higher), severe tachycardia, restlessness, agitation, and tremor. Unconsciousness, coma, hypotension, and heart failure may ensue |
| Treatment for thyotoxic crisis | high K-iodide or iodine dose to supress release of iodine, beta blockers to decrease heart rate, and PTU to suppress thyroid hormone synthesis; sedation, cooling, glucocorticoids, and IV fluids |
| Levothyroxine | Prototype synthetic T4 hormone for patients who require hormone replacement (HYPOthyroidism) |
| Administration of levothyroxine | taken on an EMPTY STOMACH in the am, 30-60 minutes before breakfast |
| Methimazole | first line of drug therapy for patients with HYPERthyroidism |
| uses of Methimazole | 1.Tx of Grave's disease; 2.lower thyroid hormones for surgical removal of the thyroid; 3.adjunct to radiation therapy until euthyroidism is acheived (3-12 wks); 4.For thyrotoxic crisis |
| Which drug is preferred for a thyrotoxic crisis: Methimazole or Propylthiouracil? | Propylthiouracil (PTU) |
| Adverse effects of Methimazole | hypothyroidism, goiter, neonatal hypothyroidism, **agranulocytosis** |
| purpose of Iodine-131 | Diminish thyroid tissue without completely destroying it |
| Contraindications for I-131 | children, pregnant, lactating |
| Advantages of I-131 | (1) low cost; (2) patients are spared the risks, discomfort, and expense of thyroid surgery; (3) death from 131I treatment is extremely rare; and (4) no tissue other than the thyroid is injured |
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