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34 Cards in this Set
- Front
- Back
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Free T4
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Best for measuring active thyroxine
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Serum T4
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used more for screening
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T3
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Measures triiodothyronine- Used for hyperthyroid
Can also monitor response to thyroid therapy |
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TSH
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Used for thyroid screening and med monitoring
*Most sensitive measure of thyroid function and can distinguish between primary and secondary disease |
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Target TSH
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1-3 mU/L
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Levothyroxine
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T4, Drug of choice for replacement, 7 day half life,
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Adverse effects of levothyroxine
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mimic hypo and hyperthyroid
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Levothyroxine interactions
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- there are drug interactions
- wait three hrs |
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May may need dose adustment when taking levothyroxine
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warfarin, digoxin, insulin
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Methiamazole (Tapazole) and Propylthiouracil (PTU)
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- Suppress thyroid hormone synthesis
- cause agranulocytosis - PTU preferred in pregancy (Tapazole crosses placenta) - Tapazole single day and PTU 3x/day |
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PTU
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- short half life (75 min)
- 6-12 months of therapy - within first 2 month causes agranulocytosis - may cause hypothyroid as well (obviously) |
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131-I
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- become hypothyroid in 3 months (TSH serial testing)
- 1/3 of pts require 2+ txs |
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Strong iodine solution (Lugol's solution)
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- used to suppress thyroid before surgery
- HIGH does of IODIDE - Therapeutic in 24 hrs, peaks in 10-14 days - First use PTU then 10 days before surgery use this - drops (2-6 drops 3x/day for 10 days) |
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Adverse effects of strong iodine solution (Lugol's solution)
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Brassy taste
Burning sensation in the mouth and throat Soreness of the teeth and gums Frontal headache Head cold Salivation Various skin eruptions **Resolve when medication discontinued |
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Beta blockers and graves
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provide symptomatic relief, may be high then tapered
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Cushing's disease
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- EXCESS of adrenal hormones
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Addison's Disease
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- DEFICIENT in adrenal hormones
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tx for Cushings
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surgical removal of adrenal gland and life time of hormone replacement
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tx for addison's
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replacement of hormones
*hydrocortisone is preferred drug |
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Hydrocortisone names
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Prednisone
Methylprednisolone (IV, medrol dose pack) Hydrocortisone sodium (Solucortef) |
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Hydrocortisone uses
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- Addison's disease
- allergy to inflammation to cancer |
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Adverse effects of hydrocortisone
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casues adrenal suppression or cushing's disease
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treatment for addison's disease
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- Cortisol replacement for life
- Aldosterone replacement if affected as well (florinef) |
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nursing during addisonian crisis
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fluid replacement
IV hydrocortisone glucose replacement |
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hydrocortisone dosing
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- dosed to create natural diurnal pattern
- 2/3 in morning - 1/3 in evening ** Needs to be increased in times of stress |
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hydrocortisone replacement education
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- low dose does not produce cushing's
- Take with food - DO NOT STOP - carry oral an injectable with you - use rx'd scale for illness, etc. - replacement is life long or could die - wear medic bracelet - tell all providers of this |
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fludrocortison (florinef)
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- promotes sodium retention and potassium loss
- used in Addison's, primary hypoaldosteronism, and congenital adrenal hyperplasia |
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Adverse effects of florinef
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- hypertension
- hypokalemia - hypernatremia - edema - cardaic enlargement |
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Somatotropin
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growth hormone
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$ OF SOMATOTROPIN
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$30,000 a yr, sub cu pens
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Cabergoline
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supression of prolactin
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Diabetes Insipidus
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lack of ADH
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tx for DI
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desmopressin (preferred)
vasopressin multiple routes and dosing scedules, usually bid |
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adverse of desmopressin
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- water intoxication
- SIADH symptoms- renal impairment - vasoconstriction- hypertension and cardiac schemia |
