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42 Cards in this Set
- Front
- Back
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The two thyroid hormones:
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T3 and T4
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More active form of thyroid hormone:
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T3
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Synthetic T3 is called:
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liothyronine
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Synthetic T4 is:
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levothyroxine
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Primary diagnostic test for thyroid:
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Serum TSH
Elevated = HYPOthyroidism Decreased = HYPERthyroidism |
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T3/T4 tests measure:
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Free AND total T3/T4
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Most common cause of hypothyroidism:
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Hashimoto's (autoimmune)
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S/s of severe hypothyroidism:
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Myxedema coma - LOC, hypothermia, hypotension, bradycardia - brought on by acute illness
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Presentation of hypothyroidism:
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Cold dry skin
Brittle hair Cold intolerance Low HR Weight gain Impaired cognition |
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Tx of hypothyroidism:
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Lifelong with T4 (Synthroid) or T3 (rarely)
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Half-life of levothyroxine:
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7 days
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Full effect of levothyroxine takes how much time?
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about a month
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Dosing of lexothryoxine:
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Once daily (long half-life)
In mcg |
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Uses of levothyroxine:
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All forms of hypothyroidism
NOT OBESITY |
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When to monitor TSH with replacement therapy:
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6-8 weeks after starting tx/changing dose
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When to take levothryoxine:
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In the AM on empty stomach
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Normal TSH level:
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0.5 - 2.0 microIU/mL
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Side effects of levothyroxine:
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Tachycardia, nervousness, tremor, SOB, angina, insomnia, hyperthermia, heat intolerance, sweating
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Special note about brands of levothyroxine:
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Don't switch them unless necessary - low therapeutic index
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Interactions with levothroxine:
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Calcium, aluminum, iron
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Most common cause of hyperthyroidism:
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Grave's disease (autoimmune)
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Presentation of hyperthyroidism:
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Rapid HR, chest pain, dysrhythmias, nervousness, insomnia, rapid speech
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Notable symptom of Grave's disease:
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Exophthalmos
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Dx of hyperthyroidism:
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High T3/T4, low TSH
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Tx of hyperthyroidism:
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Radioactive iodine, anti-thyroid medication, surgery
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Action of PTU:
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inhibits thyroid hormone synthesis without affecting existing stores (1 months' worth, usually)
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Half-life of PTU:
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About 75 minutes!
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Full benefits of PTU take how much time?
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3-12 months
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PTU is associated with:
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agranulocytosis
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First signs of agranulocytosis:
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Sore throat and fever
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Preferred tx during pregnancy for hyperthyroid:
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PTU
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Half-life of Tapazole:
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4-6 hours
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Pregnancy & Tapazole:
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Absolute contraindication
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Tx of choice for Grave's disease:
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Radioactive iodine-131
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Half-life of I-131:
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8 days
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Action of I-131:
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Thyroid takes up iodine, and radiation destroys thyroid tissue without affecting any other tissue
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Time to effect with I-131:
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2-3 months
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Disadvantage of I-131:
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Delayed hypothyroidism in most patients
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Pregnancy and I-131:
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Absolute contraindication
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Advantage of I-131:
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Cheap, no surgery, low side effect profile, safe
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Dosage of I-131:
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milliCuries?
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Use of propranolol in hyperthyroidism:
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Helps with s/s by reducing HR, nervousness, tremor (beta-blocker!)
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